Individual provider Active NPI

Andrew Gibson

  • Physical Therapist
  • Woodbury, NJ
National Provider Identifier
1699662403
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02333300 Issued in NJ
Practice address
603 N Broad St Ste 100
Woodbury, NJ 08096-1619
Phone
(856) 845-4488
NPI assigned
Jun 23, 2025
Last updated
Jan 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA02333300 NJ Primary

Addresses

Primary practice location

603 N Broad St Ste 100
Woodbury, NJ 08096-1619

Mailing address

907 Station Ave
Haddon Heights, NJ 08035-1645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260203002264 NJ Practitioner - Physical Therapist in Private Practice 0143708800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2144 Route 130
Suite 12
Bordentown, NJ 08505

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02333300NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics SPT Inc CurrentSince Jan 12, 2026 Accepting new patients
Rehabclinics SPT, Inc. CurrentSince Jan 12, 2026 Accepting new patients

Locations

707 N Main St
Glassboro, NJ 08028
Phone (856) 307-9700

127 Bridgeton Pike
Unit D
Mullica Hill, NJ 08062
Phone (856) 478-0275

603 N Broad St
Ste 100
Woodbury, NJ 08096
Phone (856) 845-4488

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1699662403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 STATION AVE",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 N BROAD ST STE 100",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961619",
            "telephone_number": "856-845-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-23",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02333300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.