Active NPI
Karen Lynn Tysonvonderheyde, PTA
- Specialist
- Mount Arlington, NJ
National Provider Identifier
1982976072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- PTA40QB00180800
- Practice address
- 2 Hillside Ave
Mount Arlington, NJ 07856 - Phone
- (973) 601-0988
- NPI assigned
- Feb 3, 2012
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | PTA40QB00180800 | NJ | Primary |
Addresses
Primary practice location
2 Hillside Ave
Mount Arlington, NJ 07856
Mailing address
154 Sandshore Road
Budd Lake, NJ 07828
Phone (973) 224-1050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00180800 | Other | NJ | NEW JERSEY STATE OF PHYSICAL THERAPY |
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 |
|---|---|---|---|
| PTA40QB00180800 | NJ | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328227200000",
"number": "1982976072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "154 SANDSHORE ROAD",
"city": "BUDD LAKE",
"state": "NJ",
"postal_code": "07828",
"telephone_number": "973-224-1050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 HILLSIDE AVE",
"city": "MOUNT ARLINGTON",
"state": "NJ",
"postal_code": "07856",
"telephone_number": "973-601-0988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYSONVONDERHEYDE",
"first_name": "KAREN",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-03",
"last_updated": "2012-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "PTA40QB00180800",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW JERSEY STATE OF PHYSICAL THERAPY",
"identifier": "00180800",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Arlington, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.