Individual provider Active NPI

Carol Ciacciarelli, P.T.

  • Physical Therapist
  • Burlington, NJ
National Provider Identifier
1801008347
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00609300 Issued in NJ
Practice address
115 Sunset Rd
Burlington, NJ 08016-4153
Phone
(609) 387-3620
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA00609300 NJ Primary

Addresses

Primary practice location

115 Sunset Rd
Burlington, NJ 08016-4153

Mailing address

557 Island Rd
Columbus, NJ 08022-2105
Phone (609) 324-7894

Other identifiers 1

IdentifierTypeStateIssuer
40QA00609300OtherNJP.T. LICENSE

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
40QA00609300NJMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801008347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 ISLAND RD",
            "city": "COLUMBUS",
            "state": "NJ",
            "postal_code": "080222105",
            "telephone_number": "609-324-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 SUNSET RD",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080164153",
            "telephone_number": "609-387-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIACCIARELLI",
        "first_name": "CAROL",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00609300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P.T. LICENSE",
            "identifier": "40QA00609300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.