Jacob Burtch

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

145134 Issued in AK

Practice address

3001 S Jackson St
San Angelo, TX 76904-5129

Phone

(325) 223-6300

Fax

(325) 793-3587

NPI assigned

Jun 18, 2019

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• The West Texas Rehabilitation Center

  • Rehabilitation Clinic/Center
  • Abilene, TX
  • NPI 1922112499

  Physical Therapist

  Medicare reassignment NPD
• The West Texas Rehabilitation Center

  • Community Based Hospice Care Agency
  • San Angelo, TX
  • NPI 1063911618
  NPD

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1124688585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 S JACKSON ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045129",
            "telephone_number": "325-223-6300",
            "fax_number": "907-376-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 S JACKSON ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045129",
            "telephone_number": "325-223-6300",
            "fax_number": "325-793-3587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTCH",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-18",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "145134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCE",
            "identifier": "14493767",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14493767",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Yeaton Burnell, RN
• Maura Eileen Burnett, SLP
• Peggy A Burpee, DO
• Brandon C Burrage, F.N.P.-C.
• Teresa A Burson, RDH
• Carolyn Burton, M.S.
• Jacob Burton, DO
• Megan Busker, DPT
• Nicole Ralston Butler, COTA
• Jessica Butts, MS, RDN, LD

• Physical Therapist in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.