Active NPI
Timothy Larson Purcell, PT
- Pediatric Physical Therapist
- Paramus, NJ
National Provider Identifier
1750390787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 40QA00794600
- Practice address
- 162 Garden Ave
Paramus, NJ 07652-1937 - Phone
- (201) 401-0859
- Fax
- (888) 568-4217
- NPI assigned
- Aug 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 40QA00794600 | NJ | Primary |
Addresses
Primary practice location
162 Garden Ave
Paramus, NJ 07652-1937
Mailing address
162 Garden Ave
Paramus, NJ 07652-1937
Phone (201) 401-0859
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750390787 | Medicaid | NJ |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00794600 | NJ | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542067200000",
"number": "1750390787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "162 GARDEN AVE",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "076521937",
"telephone_number": "201-401-0859",
"fax_number": "888-568-4217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "162 GARDEN AVE",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "076521937",
"telephone_number": "201-401-0859",
"fax_number": "888-568-4217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURCELL",
"first_name": "TIMOTHY",
"middle_name": "LARSON",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2018-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NJ",
"license": "40QA00794600",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1750390787",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paramus, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.