Individual provider Active NPI

Timothy Ehret, D.P.T.

  • Physical Therapist
  • Johnson City, NY
National Provider Identifier
1720313547
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT021243 Issued in PA
Practice address
800 Valley PLZ
Ste 9
Johnson City, NY 13790-1046
Phone
(607) 729-2200
Fax
(607) 729-2202
NPI assigned
Oct 13, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1191668 TX
Physical Therapist 225100000X PT021243 PA Primary
Physical Therapist 225100000X 038242 NY

Addresses

Primary practice location

800 Valley PLZ
Ste 9
Johnson City, NY 13790-1046

Mailing address

800 Valley PLZ
Ste 9
Johnson City, NY 13790-1046
Phone (607) 729-2200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150707000023 NY Practitioner - Physical Therapist in Private Practice 7719175173 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038242NYMDPhysical Therapist
PT021243PAMDPhysical Therapist
1191668TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Broome Orthopedic & Sport Physical Therapy CurrentSince Oct 12, 2021 Accepting new patients
Cleburne Physical Therapy & Sports Rehabilitation, Inc. Physical Therapist PastSince Apr 1, 2001 Accepting new patients

Locations

800 Valley Plz
Ste 9
Johnson City, NY 13790
Phone (607) 729-2200

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1720313547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 VALLEY PLZ",
            "address_2": "STE 9",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901046",
            "telephone_number": "607-729-2200",
            "fax_number": "607-729-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 VALLEY PLZ",
            "address_2": "STE 9",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901046",
            "telephone_number": "607-729-2200",
            "fax_number": "607-729-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRET",
        "first_name": "TIMOTHY",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-13",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1191668",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT021243",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "038242",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.