Active NPI
Jake R Porsch, PT
- Physical Therapist
- Garland, TX
National Provider Identifier
1124379722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1218719
- Practice address
- 2046 Forest LN Ste 180
Garland, TX 75042-7939 - Phone
- (972) 494-1419
- Fax
- (972) 494-2069
- NPI assigned
- Sep 24, 2012
- 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 | 1218719 | TX | Primary |
Addresses
Primary practice location
2046 Forest LN Ste 180
Garland, TX 75042-7939
Mailing address
2046 Forest LN Ste 180
Garland, TX 75042-7939
Phone (972) 494-1419
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 |
|---|---|---|---|
| 1218719 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348444800000",
"number": "1124379722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2046 FOREST LN STE 180",
"city": "GARLAND",
"state": "TX",
"postal_code": "750427939",
"telephone_number": "972-494-1419",
"fax_number": "972-494-2069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2046 FOREST LN STE 180",
"city": "GARLAND",
"state": "TX",
"postal_code": "750427939",
"telephone_number": "972-494-1419",
"fax_number": "972-494-2069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORSCH",
"first_name": "JAKE",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-24",
"last_updated": "2012-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1218719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.