Individual provider Active NPI

Jacobey Tipton

  • Physical Therapist
  • Cleburne, TX
National Provider Identifier
1023711207
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1014 N Nolan River Rd Unit a
Cleburne, TX 76033-7936
Phone
(817) 406-1408
NPI assigned
Mar 24, 2023
Last updated
Mar 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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 TX Primary

Addresses

Primary practice location

1014 N Nolan River Rd Unit a
Cleburne, TX 76033-7936

Mailing address

1700 Brenwood Dr
Mesquite, TX 75181-1750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230717001783 TX Practitioner - Physical Therapist in Private Practice 9537529995 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cleburne Physical Therapy & Sports Rehabilitation, Inc. Physical Therapist CurrentSince Jun 1, 2023 Accepting new patients
Texas Health Huguley, Inc. PastSince Mar 26, 2023 Accepting new patients
Texas Health Huguley, Inc PastSince Mar 26, 2023 Accepting new patients

Locations

1014 N Nolan River Rd
Cleburne, TX 76033
Phone (817) 641-8617

1014 N Nolan River Rd
Unit A
Cleburne, TX 76033
Phone (817) 406-1408

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1023711207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 BRENWOOD DR",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751811750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 N NOLAN RIVER RD UNIT A",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337936",
            "telephone_number": "817-406-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPTON",
        "first_name": "JACOBEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.