NPIMap

Organization Active NPI

Jag-One Physical Therapy, LLC

  • Occupational Therapist
  • Chatham, NJ
National Provider Identifier
1831660323
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
JAG-ONE PHYSICAL THERAPY, LLC
Practice address
461 Main St
Chatham, NJ 07928-2102
Phone
(973) 635-1000
NPI assigned
Dec 10, 2018
Last updated
Aug 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Authorized official

Name
Luann M Teetsell
Title
Credentialing Manager
Phone
(718) 844-5350

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

461 Main St
Chatham, NJ 07928-2102

Mailing address

900 Route 9 N
Woodbridge, NJ 07095-1025
Phone (201) 801-7141

Other names 1

  • Jag Physical Therapy LLC Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565049600000",
    "number": "1831660323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ROUTE 9 N",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951025",
            "telephone_number": "201-801-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 MAIN ST",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282102",
            "telephone_number": "973-635-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAG-ONE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-10",
        "last_updated": "2019-08-06",
        "status": "A",
        "authorized_official_last_name": "TEETSELL",
        "authorized_official_first_name": "LUANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "718-844-5350"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jag Physical Therapy LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Chatham, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.