Individual provider Active NPI

Erica Blake Person, PT

  • Physical Therapist
  • East Northport, NY
National Provider Identifier
1902055437
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
018783-0 Issued in NY
Practice address
554 Larkfield Rd
Suite 207
East Northport, NY 11731-4205
Phone
(631) 266-4501
Fax
(631) 266-4502
NPI assigned
Sep 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 018783-0 NY Primary
Geriatric Physical Therapist 2251G0304X 018783-0 NY
Orthopedic Physical Therapist 2251X0800X 018783-0 NY

Addresses

Primary practice location

554 Larkfield Rd
Suite 207
East Northport, NY 11731-4205

Mailing address

554 Larkfield Rd
Suite 207
East Northport, NY 11731-4205
Phone (631) 266-4501

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
018783-0NYMDGeriatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1902055437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 LARKFIELD RD",
            "address_2": "SUITE 207",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117314205",
            "telephone_number": "631-266-4501",
            "fax_number": "631-266-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 LARKFIELD RD",
            "address_2": "SUITE 207",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117314205",
            "telephone_number": "631-266-4501",
            "fax_number": "631-266-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSON",
        "first_name": "ERICA",
        "middle_name": "BLAKE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "018783-0",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NY",
            "license": "018783-0",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "018783-0",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.