Individual provider Active NPI

Austin Redfearn

  • Physical Therapist
  • West Deptford, NJ
National Provider Identifier
1891671608
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02353600 Issued in NJ
Practice address
875 Mantua Pike Ste 14
West Deptford, NJ 08096-3337
Phone
(856) 333-3691
NPI assigned
Aug 15, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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 40QA02353600 NJ Primary

Addresses

Primary practice location

875 Mantua Pike Ste 14
West Deptford, NJ 08096-3337

Mailing address

875 Mantua Pike Ste 14
West Deptford, NJ 08096-3337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251007003583 NJ Practitioner - Physical Therapist in Private Practice 7214434174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

875 Mantua Pike
Suite 14
West Deptford, NJ 08096-3337
Phone (856) 333-3691

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc Physical Therapist CurrentSince Aug 15, 2025 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Aug 15, 2025 Accepting new patients
Ivyrehab Network Inc. Physical Therapist Current Accepting new patients

Locations

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

875 Mantua Pike
Ste 14
West Deptford, NJ 08096
Phone (856) 333-3691

Organizations & group practices 3

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": "1755216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1891671608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 MANTUA PIKE STE 14",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080963337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 MANTUA PIKE STE 14",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080963337",
            "telephone_number": "856-333-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDFEARN",
        "first_name": "AUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02353600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Deptford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.