Active NPI
Jacob Medina, PT, DPT
- Physical Therapist
- Plano, TX
National Provider Identifier
1033944723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1397453
- Practice address
- 1100 Allied Dr
Plano, TX 75093-5348 - Phone
- (469) 814-3278
- NPI assigned
- Sep 3, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1397453 | TX | Primary |
Addresses
Primary practice location
1100 Allied Dr
Plano, TX 75093-5348
Mailing address
8189 Midtown Blvd Apt 12316
Dallas, TX 75231-4562
Phone (281) 986-0298
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 |
|---|---|---|---|
| 1397453 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725321600000",
"number": "1033944723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8189 MIDTOWN BLVD APT 12316",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314562",
"telephone_number": "281-986-0298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 ALLIED DR",
"city": "PLANO",
"state": "TX",
"postal_code": "750935348",
"telephone_number": "469-814-3278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "JACOB",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-03",
"last_updated": "2024-09-03",
"certification_date": "2024-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1397453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.