Active NPI
Jeremy Calzada, PT
- Physical Therapist
- Fort Stockton, TX
National Provider Identifier
1083014666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1172767
- Practice address
- 387 W Ih 10 # B
Fort Stockton, TX 79735-2700 - Phone
- (432) 336-5544
- Fax
- (432) 336-5590
- NPI assigned
- Sep 2, 2014
- 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 | 1172767 | TX | Primary |
Addresses
Primary practice location
387 W Ih 10 # B
Fort Stockton, TX 79735-2700
Mailing address
387 W Ih 10 # B
Fort Stockton, TX 79735-2700
Phone (432) 336-5544
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 |
|---|---|---|---|
| 1172767 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409616000000",
"number": "1083014666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "387 W IH 10 # B",
"city": "FORT STOCKTON",
"state": "TX",
"postal_code": "797352700",
"telephone_number": "432-336-5544",
"fax_number": "432-336-5590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "387 W IH 10 # B",
"city": "FORT STOCKTON",
"state": "TX",
"postal_code": "797352700",
"telephone_number": "432-336-5544",
"fax_number": "432-336-5590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALZADA",
"first_name": "JEREMY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-02",
"last_updated": "2014-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1172767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Stockton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.