Active NPI
Jessica Quinn
- Physical Therapist
- Dayton, OH
National Provider Identifier
1104189109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT013726
- Practice address
- 4710 Old Troy Pike
Dayton, OH 45424-5740 - Phone
- (937) 233-3210
- Fax
- (937) 236-8930
- NPI assigned
- Jun 25, 2012
- Sex
- Female
- 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 | PT013726 | OH | Primary |
Addresses
Primary practice location
4710 Old Troy Pike
Dayton, OH 45424-5740
Mailing address
4710 Old Troy Pike
Dayton, OH 45424-5740
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0510772 | Medicaid | OH |
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 |
|---|---|---|---|
| PT013726 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340582400000",
"number": "1104189109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4710 OLD TROY PIKE",
"city": "DAYTON",
"state": "OH",
"postal_code": "454245740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4710 OLD TROY PIKE",
"city": "DAYTON",
"state": "OH",
"postal_code": "454245740",
"telephone_number": "937-233-3210",
"fax_number": "937-236-8930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINN",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-25",
"last_updated": "2012-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT013726",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0510772",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.