Individual provider Active NPI

Jeff Hepburn, PTA

  • Physical Therapy Assistant
  • Red Bluff, CA
National Provider Identifier
1154753960
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AT8898 Issued in CA
Practice address
555 Luther Rd
Red Bluff, CA 96080-9672
Phone
(530) 527-6341
NPI assigned
Aug 2, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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 AT8898 CA Primary

Addresses

Primary practice location

555 Luther Rd
Red Bluff, CA 96080-9672

Mailing address

12873 Gardenia Ave
Red Bluff, CA 96080-9672

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
AT8898CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1154753960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12873 GARDENIA AVE",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960809672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 LUTHER RD",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960809672",
            "telephone_number": "530-527-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEPBURN",
        "first_name": "JEFF",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-02",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT8898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bluff, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; 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.