Active NPI
Job Jean
- Physical Therapist
- Dover, DE
National Provider Identifier
1134503584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- J1-0003124
- Practice address
- 29 Jillian Dr
Dover, DE 19901-5895 - Phone
- (302) 242-4703
- NPI assigned
- Jul 15, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 | J1-0003124 | DE | Primary |
Addresses
Primary practice location
29 Jillian Dr
Dover, DE 19901-5895
Mailing address
29 Jillian Dr
Dover, DE 19901-5895
Phone (302) 242-4703
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1812 Marsh Rd
Wilmington, DE 19810-4581
Phone (302) 475-7500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25080 | MD | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| J1-0003124 | DE | MD | Physical Therapist |
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": "1436918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436918400000",
"number": "1134503584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 JILLIAN DR",
"city": "DOVER",
"state": "DE",
"postal_code": "199015895",
"telephone_number": "302-242-4703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 JILLIAN DR",
"city": "DOVER",
"state": "DE",
"postal_code": "199015895",
"telephone_number": "302-242-4703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEAN",
"first_name": "JOB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-15",
"last_updated": "2015-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DE",
"license": "J1-0003124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dover, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.