Active NPI
Jody Ann Nicosia, PT, DPT
- Physical Therapist
- Havertown, PA
National Provider Identifier
1962024216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT025425
- Practice address
- 2000 Old West Chester Pike
Havertown, PA 19083-2712 - Phone
- (610) 536-2100
- NPI assigned
- May 9, 2020
- 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 | PT025425 | PA | Primary |
Addresses
Primary practice location
2000 Old West Chester Pike
Havertown, PA 19083-2712
Mailing address
4657 Woodland Ave
Drexel Hill, PA 19026-4328
Phone (856) 899-0599
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT025425 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588982400000",
"number": "1962024216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4657 WOODLAND AVE",
"city": "DREXEL HILL",
"state": "PA",
"postal_code": "190264328",
"telephone_number": "856-899-0599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 OLD WEST CHESTER PIKE",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190832712",
"telephone_number": "610-536-2100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOSIA",
"first_name": "JODY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-09",
"last_updated": "2020-05-09",
"certification_date": "2020-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT025425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Havertown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.