Jody Maureen Flynn X, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA40QB00220400 Issued in NJ

Practice address

160 Paris Ave Ste 2
Northvale, NJ 07647-2043

Phone

(201) 767-6700

NPI assigned

Aug 15, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Northern Valley Physical Therapy PA

  • Physical Therapy Clinic/Center
  • River Vale, NJ
  • NPI 1629096292

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502755200000",
    "number": "1861918484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SYCAMORE CT",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753512",
            "telephone_number": "201-497-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 PARIS AVE STE 2",
            "city": "NORTHVALE",
            "state": "NJ",
            "postal_code": "076472043",
            "telephone_number": "201-767-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "JODY",
        "middle_name": "MAUREEN",
        "name_suffix": "X",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2017-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "PTA40QB00220400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbey Raia Fallon, BSED, ATC, LAT
• Henry Scott Farah, M.D.
• First Med Family Health Care LLC
• Firstmed Family Healthcare LLC
• William Edward Fisher, PA
• Frederick M Weintraub
• Evelyn Ghadimian
• Darren Vincent Gioffre, OT
• Give Chances, Inc.
• Sally Gresla, OT

• Physical Therapy Assistant in Northvale, NJ
• Providers in Northvale, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; 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.