Individual provider Active NPI

Dwight Jones, PTA

  • Physical Therapy Assistant
  • San Diego, CA
National Provider Identifier
1154624088
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AT862 Issued in CA
Practice address
13400 Sabre Springs Pkwy, #100
San Diego, CA 92128
Phone
(858) 212-1944
NPI assigned
Dec 15, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AT862 CA Primary

Addresses

Primary practice location

13400 Sabre Springs Pkwy, #100
San Diego, CA 92128

Mailing address

PO Box 17448
San Diego, CA 92177-7448
Phone (858) 212-1944

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

LicenseStateTypeSpecialty
AT862CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1154624088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17448",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921777448",
            "telephone_number": "858-212-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 SABRE SPRINGS PKWY, #100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92128",
            "telephone_number": "858-212-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "DWIGHT",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-15",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.