Active NPI
Jane Davis, PT, MSHP
- Pediatric Physical Therapist
- Montgomery, TX
National Provider Identifier
1053774349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 1-3699-4
- Practice address
- 64 April Wind Dr S
Montgomery, TX 77356-5966 - Phone
- (936) 524-3979
- NPI assigned
- Apr 4, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 1-3699-4 | TX | Primary |
Addresses
Primary practice location
64 April Wind Dr S
Montgomery, TX 77356-5966
Mailing address
64 April Wind Dr S
Montgomery, TX 77356-5966
Phone (936) 524-3979
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 |
|---|---|---|---|
| 1-3699-4 | TX | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459728000000",
"number": "1053774349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 APRIL WIND DR S",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773565966",
"telephone_number": "936-524-3979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 APRIL WIND DR S",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773565966",
"telephone_number": "936-524-3979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JANE",
"name_prefix": "Mrs.",
"credential": "PT, MSHP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-04",
"last_updated": "2016-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "TX",
"license": "1-3699-4",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.