Active NPI
Justine Danielle Burrell, PT
- Physical Therapist
- Forest City, PA
National Provider Identifier
1891924601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT020022
- Practice address
- 354 Main St
Forest City, PA 18421-1418 - Phone
- (570) 785-2018
- Fax
- (570) 785-2061
- NPI assigned
- Jul 14, 2009
- Last updated
- Nov 2, 2010
- 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 Therapist | 225100000X | PT020022 | PA | Primary |
Addresses
Primary practice location
354 Main St
Forest City, PA 18421-1418
Mailing address
441 Marion St
Browndale, PA 18421-1228
Phone (570) 960-1782
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT020022 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288656000000",
"number": "1891924601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "441 MARION ST",
"city": "BROWNDALE",
"state": "PA",
"postal_code": "184211228",
"telephone_number": "570-960-1782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "354 MAIN ST",
"city": "FOREST CITY",
"state": "PA",
"postal_code": "184211418",
"telephone_number": "570-785-2018",
"fax_number": "570-785-2061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURRELL",
"first_name": "JUSTINE",
"middle_name": "DANIELLE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-14",
"last_updated": "2010-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT020022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest City, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.