Active NPI
Mary Burke
- Physical Therapist
- Wall Township, NJ
National Provider Identifier
1982431201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00940500
- Practice address
- 2500 Ridgewood Rd
Wall Township, NJ 07719-9600 - Phone
- (732) 528-9311
- NPI assigned
- Sep 19, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 40QA00940500 | NJ | Primary |
Addresses
Primary practice location
2500 Ridgewood Rd
Wall Township, NJ 07719-9600
Mailing address
103 3Rd Ave Apt 2
Bradley Beach, NJ 07720-1259
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 |
|---|---|---|---|
| 40QA00940500 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726704000000",
"number": "1982431201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 3RD AVE APT 2",
"city": "BRADLEY BEACH",
"state": "NJ",
"postal_code": "077201259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 RIDGEWOOD RD",
"city": "WALL TOWNSHIP",
"state": "NJ",
"postal_code": "077199600",
"telephone_number": "732-528-9311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-19",
"last_updated": "2024-09-19",
"certification_date": "2024-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00940500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wall Township, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.