NPIMap

Organization Active NPI

Andover Mohawk Physical Therapy

  • Physical Therapy Clinic/Center
  • Andover, NJ
National Provider Identifier
1700041795
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
40QA00588000 Issued in NJ
Legal business name
ANDOVER MOHAWK PHYSICAL THERAPY
Practice address
8 Lenape Rd
Andover, NJ 07821-4568
Phone
(973) 786-6045
Fax
(973) 786-6054
NPI assigned
Jul 19, 2008
Last updated
Mar 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Authorized official

Name
Christina B Jonsson, MPTNPI 1902956394
Title
Physical Therapist
Phone
(973) 786-6045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 40QA00588000 NJ Primary
Physical Therapy Clinic/Center 261QP2000X 40QAO1129700 NJ

Addresses

Primary practice location

8 Lenape Rd
Andover, NJ 07821-4568

Mailing address

8 Lenape Rd
Andover, NJ 07821-4568
Phone (973) 786-6045

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090305000313 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4981760535 Receives reassigned benefits from 4 practitioners
Practice locations: Andover, NJ

National Provider Directory

National Provider Directory

Locations

8 Lenape Rd
Andover, NJ 07821
Phone (973) 786-0235

8 Lenape Rd
Ste B
Andover, NJ 07821

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1216425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1700041795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 LENAPE RD",
            "city": "ANDOVER",
            "state": "NJ",
            "postal_code": "078214568",
            "telephone_number": "973-786-6045",
            "fax_number": "973-786-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 LENAPE RD",
            "city": "ANDOVER",
            "state": "NJ",
            "postal_code": "078214568",
            "telephone_number": "973-786-6045",
            "fax_number": "973-786-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDOVER MOHAWK PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-19",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "JONSSON",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "973-786-6045",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA00588000",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QAO1129700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.