Individual provider Active NPI

Danielle Goldberg, PTA

  • Physical Therapy Assistant
  • Columbus, OH
National Provider Identifier
1700601762
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA013043 Issued in OH
Practice address
1930 Crown Park CT Ste 100
Columbus, OH 43235-2402
Phone
(614) 695-3747
NPI assigned
Nov 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA013043 OH Primary

Addresses

Primary practice location

1930 Crown Park CT Ste 100
Columbus, OH 43235-2402

Mailing address

100 Columbus Ave
Delaware, OH 43015-2464

Other practice location 1

9200 Worthington Rd Ste 300
Westerville, OH 43082-7240
Phone (614) 433-0031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA013043OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1700601762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COLUMBUS AVE",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430152464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 CROWN PARK CT STE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432352402",
            "telephone_number": "614-695-3747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 Worthington Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430827240",
            "country_code": "US",
            "telephone_number": "614-433-0031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "DANIELLE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA013043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.