Active NPI
Reysan Jamotuya
- Physical Therapist
- Corpus Christi, TX
National Provider Identifier
1164895447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1182130
- Practice address
- 7710 Fort Griffin Dr
Corpus Christi, TX 78414-5783 - Phone
- (361) 343-1362
- NPI assigned
- Nov 9, 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 | 1182130 | TX | Primary |
Addresses
Primary practice location
7710 Fort Griffin Dr
Corpus Christi, TX 78414-5783
Mailing address
7710 Fort Griffin Dr
Corpus Christi, TX 78414-5783
Phone (361) 343-1362
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1182130 | Other | TX | PT LICENSE NUMBER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1182130 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447027200000",
"number": "1164895447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7710 FORT GRIFFIN DR",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784145783",
"telephone_number": "361-343-1362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7710 FORT GRIFFIN DR",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784145783",
"telephone_number": "361-343-1362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMOTUYA",
"first_name": "REYSAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-11-09",
"last_updated": "2015-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1182130",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE NUMBER",
"identifier": "1182130",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corpus Christi, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.