Individual provider Active NPI

Jeffrey Wayne Sapp Jr., PTA

  • Physical Therapy Assistant
  • Kingwood, WV
National Provider Identifier
1073806188
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A-0564 Issued in NV
Practice address
421 Morgantown St
Kingwood, WV 26537-1095
Phone
(304) 329-3739
Fax
(304) 329-3250
NPI assigned
May 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A-0564 NV Primary

Addresses

Primary practice location

421 Morgantown St
Kingwood, WV 26537-1095

Mailing address

421 Morgantown St
Kingwood, WV 26537-1095
Phone (304) 329-3739

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

LicenseStateTypeSpecialty
A-0564NVMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Preston Rehabilitation & Orthopedic Physical Therapy, Inc PastSince Jan 1, 2004 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1073806188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 MORGANTOWN ST",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371095",
            "telephone_number": "304-329-3739",
            "fax_number": "304-329-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 MORGANTOWN ST",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371095",
            "telephone_number": "304-329-3739",
            "fax_number": "304-329-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAPP",
        "first_name": "JEFFREY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-23",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NV",
            "license": "A-0564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.