Active NPI
Angela M McKendree
- Physical Therapist
- Johnstown, PA
National Provider Identifier
1790971083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT010012L
- Practice address
- 111 Market St
Johnstown, PA 15901-1608 - Phone
- (814) 539-1919
- Fax
- (814) 539-1308
- NPI assigned
- Sep 20, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT010012L | PA | Primary |
Addresses
Primary practice location
111 Market St
Johnstown, PA 15901-1608
Mailing address
111 Market St
Johnstown, PA 15901-1608
Phone (814) 539-1919
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT010012L | Medicaid | PA |
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 |
|---|---|---|---|
| PT010012L | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beginnings, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1190246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208822400000",
"number": "1790971083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 MARKET ST",
"city": "JOHNSTOWN",
"state": "PA",
"postal_code": "159011608",
"telephone_number": "814-539-1919",
"fax_number": "814-539-1308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MARKET ST",
"city": "JOHNSTOWN",
"state": "PA",
"postal_code": "159011608",
"telephone_number": "814-539-1919",
"fax_number": "814-539-1308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENDREE",
"first_name": "ANGELA",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-20",
"last_updated": "2008-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT010012L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PT010012L",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Johnstown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.