Active NPI
Jake Hoover
- Physical Therapy Assistant
- Overland Park, KS
National Provider Identifier
1043089170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 14-04062
- Practice address
- 12000 Lamar Ave
Overland Park, KS 66209 - Phone
- (913) 663-2888
- NPI assigned
- Dec 29, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 14-04062 | KS | Primary |
Addresses
Primary practice location
12000 Lamar Ave
Overland Park, KS 66209
Mailing address
5954 Woodson St Apt 107
Mission, KS 66202-3309
Phone (913) 424-4051
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 |
|---|---|---|---|
| 14-04062 | KS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1703808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703808000000",
"number": "1043089170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5954 WOODSON ST APT 107",
"city": "MISSION",
"state": "KS",
"postal_code": "662023309",
"telephone_number": "913-424-4051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12000 LAMAR AVE",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "66209",
"telephone_number": "913-663-2888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOOVER",
"first_name": "JAKE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-12-29",
"last_updated": "2023-12-29",
"certification_date": "2023-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "14-04062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.