Individual provider Active NPI

Cedric Peji, PT

  • Physical Therapist
  • Mesquite, TX
National Provider Identifier
1003567389
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1355762 Issued in TX
Practice address
1650 Republic Pkwy Ste 103
Mesquite, TX 75150-6926
Phone
(972) 698-1145
NPI assigned
Jan 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1355762 TX Primary

Addresses

Primary practice location

1650 Republic Pkwy Ste 103
Mesquite, TX 75150-6926

Mailing address

3521 Thunder Dr
Sachse, TX 75048-4363
Phone (469) 931-9530

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1355762TXMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1003567389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 THUNDER DR",
            "city": "SACHSE",
            "state": "TX",
            "postal_code": "750484363",
            "telephone_number": "469-931-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 REPUBLIC PKWY STE 103",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506926",
            "telephone_number": "972-698-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEJI",
        "first_name": "CEDRIC",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1355762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.