Individual provider Active NPI

Atim Ekong Okengwu, PT

  • Physical Therapist
  • Linden, NJ
National Provider Identifier
1871733394
Registry record updated Feb 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT40QA007134 Issued in NJ
Practice address
Delaire Nursing and Convalescent Center
400 West Stimpson Ave
Linden, NJ 07036-4499
Phone
(908) 862-3399
Fax
(908) 862-6967
NPI assigned
Feb 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2009

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 PT40QA007134 NJ Primary

Addresses

Primary practice location

Delaire Nursing and Convalescent Center
400 West Stimpson Ave
Linden, NJ 07036-4499

Mailing address

14 Zirkel Ave
Piscataway, NJ 08854-5714
Phone (732) 463-0187

Other names 1

  • Miss Atim Ekong Okengwu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200116001177 NJ Practitioner - Physical Therapist in Private Practice 6608201801 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT40QA007134NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Inc Physical Therapist CurrentSince Dec 5, 2019 Accepting new patients
Foundation for HIV/AIDS & Kidney Dialysis Inc. Past Accepting new patients

Locations

872 E Main St
Bridgewater, NJ 08807
Phone (908) 725-2995

407 W Delilah Rd
Pleasantville, NJ 08232
Phone (609) 289-2331

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235433600000",
    "number": "1871733394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 ZIRKEL AVE",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088545714",
            "telephone_number": "732-463-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DELAIRE NURSING AND CONVALESCENT CENTER",
            "address_2": "400 WEST STIMPSON AVE",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070364499",
            "telephone_number": "908-862-3399",
            "fax_number": "908-862-6967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKENGWU",
        "first_name": "ATIM",
        "middle_name": "EKONG",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2009-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "PT40QA007134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ATIM",
            "last_name": "OKENGWU",
            "middle_name": "EKONG",
            "prefix": "MISS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Linden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.