Individual provider Active NPI

Joseph Rennold Whiting

  • Orthopedic Physical Therapist
  • Ridgewood, NJ
National Provider Identifier
1962265926
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
40QA02235200 Issued in NJ
Practice address
104 Chestnut St
Ridgewood, NJ 07450-2502
Phone
(201) 493-8111
NPI assigned
Feb 2, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X 40QA02235200 NJ Primary

Addresses

Primary practice location

104 Chestnut St
Ridgewood, NJ 07450-2502

Mailing address

210 S Van Dien Ave
Ridgewood, NJ 07450-5216
Phone (201) 753-8835

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240307000012 NJ Practitioner - Physical Therapist in Private Practice 1052757572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Home Therapy LLCGroup PAC ID 1254746340, 50 clinicians

Practice addresses (Care Compare)

106 Prospect St
Ridgewood, NJ 07450-4433
Phone (201) 493-8111

70 S Orange Ave
Suite 220
Livingston, NJ 07039-4920
Phone (917) 751-8706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgewood Physical Therapy and Rehabilitation Center Inc. Single Specialty CurrentSince Feb 2, 2024 Accepting new patients
Life Home Therapy LLC Orthopedic CurrentSince Jun 13, 2025 Accepting new patients

Locations

70 S Orange Ave
Ste 220
Livingston, NJ 07039
Phone (973) 626-2350

104 Chestnut St
Ridgewood, NJ 07450
Phone (201) 493-8111

106 Prospect St
Ridgewood, NJ 07450
Phone (201) 493-8111

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": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1962265926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S VAN DIEN AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074505216",
            "telephone_number": "201-753-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CHESTNUT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502502",
            "telephone_number": "201-493-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITING",
        "first_name": "JOSEPH",
        "middle_name": "RENNOLD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA02235200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.