Active NPI
Mary A. Allison, PTA
- Physical Therapy Assistant
- Blackwood, NJ
National Provider Identifier
1821210493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 40QB00092500
- Practice address
- 20 N Woodbury Turnersville Rd
Blackwood, NJ 08012-2888 - Phone
- (856) 374-6665
- NPI assigned
- May 3, 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 Therapy Assistant | 225200000X | 40QB00092500 | NJ | Primary |
Addresses
Primary practice location
20 N Woodbury Turnersville Rd
Blackwood, NJ 08012-2888
Mailing address
14 Shannon Lane
Winslow, NJ 08095
Phone (609) 567-0669
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40QB00092500 | Other | NJ | STATE 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
| License | State | Type | Specialty |
|---|---|---|---|
| 40QB00092500 | NJ | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821210493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 SHANNON LANE",
"city": "WINSLOW",
"state": "NJ",
"postal_code": "08095",
"telephone_number": "609-567-0669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 N WOODBURY TURNERSVILLE RD",
"city": "BLACKWOOD",
"state": "NJ",
"postal_code": "080122888",
"telephone_number": "856-374-6665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLISON",
"first_name": "MARY",
"middle_name": "A.",
"name_prefix": "Ms.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NJ",
"license": "40QB00092500",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "40QB00092500",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Blackwood, 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.