Active NPI
Jonathan Hines
- Athletic Trainer
- Red Oak, TX
National Provider Identifier
1164193371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1913 Willow Bend Dr
Red Oak, TX 75154-3871 - Phone
- (214) 815-7006
- NPI assigned
- Sep 27, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | TX | ||
| Athletic Trainer | 2255A2300X | TX | Primary |
Addresses
Primary practice location
1913 Willow Bend Dr
Red Oak, TX 75154-3871
Mailing address
1913 Willow Bend Dr
Red Oak, TX 75154-3871
Phone (214) 815-7006
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633392000000",
"number": "1164193371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1913 WILLOW BEND DR",
"city": "RED OAK",
"state": "TX",
"postal_code": "751543871",
"telephone_number": "214-815-7006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1913 WILLOW BEND DR",
"city": "RED OAK",
"state": "TX",
"postal_code": "751543871",
"telephone_number": "214-815-7006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HINES",
"first_name": "JONATHAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-09-27",
"last_updated": "2021-10-05",
"certification_date": "2021-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "TX",
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Oak, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.