Jean E Erdal, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0003674 Issued in FL

Practice address

2063 Hovington Cir W
Jacksonville, FL 32246-7065

Phone

(904) 220-5693

NPI assigned

Aug 30, 2006

Last updated

Mar 26, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238025600000",
    "number": "1013027507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2063 HOVINGTON CIR W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467065",
            "telephone_number": "904-220-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2063 HOVINGTON CIR W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467065",
            "telephone_number": "904-220-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERDAL",
        "first_name": "JEAN",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "0003674",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "01072",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40407800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• ER Companion LLC
• Daniel Ruben Eraso, MD
• Samantha Adair Erb, DO
• Teresa M Erb, MD
• Young Mi Erben, M.D.
• Michael Joseph Erdman, PHARMD
• Elisa Ereckson, APRN
• Christina Joelene Erford, DNP, APRN, NP-C
• Ergo Body Inc. (Ergo Body)
• Michael J. Erhard, MD

• Physical Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; 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.