Jaycee Cabalatungan Cristales, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070023533 Issued in IL

Practice address

136 S Dipper LN
Decatur, IL 62522-1841

Phone

(217) 428-7767

NPI assigned

Mar 13, 2019

Last updated

Mar 13, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1073072609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 S COUNTRY CLUB RD APT 107",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625214486",
            "telephone_number": "405-328-8673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S DIPPER LN",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625221841",
            "telephone_number": "217-428-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISTALES",
        "first_name": "JAYCEE",
        "middle_name": "CABALATUNGAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070023533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Decatur, IL
• Providers in Decatur, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; 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.