Individual provider Active NPI

Jill E Landgrebe, P.T.A.

  • Physical Therapy Assistant
  • Collegeville, PA
National Provider Identifier
1821116617
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TEI000748 Issued in PA
Practice address
409 2ND Ave
Suite 202
Collegeville, PA 19426-3625
Phone
(610) 489-5772
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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 TEI000748 PA Primary

Addresses

Primary practice location

409 2ND Ave
Suite 202
Collegeville, PA 19426-3625

Mailing address

409 2ND Ave
Suite 202
Collegeville, PA 19426-3625
Phone (610) 489-5772

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
TEI000748PAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1821116617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 2ND AVE",
            "address_2": "SUITE 202",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194263625",
            "telephone_number": "610-489-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 2ND AVE",
            "address_2": "SUITE 202",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194263625",
            "telephone_number": "610-489-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDGREBE",
        "first_name": "JILL",
        "middle_name": "E",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI000748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collegeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.