Jennifer M Washington, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2075603 Issued in TX

Practice address

5505 New Copeland Rd
Tyler, TX 75703-3955

Phone

(855) 840-7257

NPI assigned

Aug 26, 2018

Last updated

Aug 26, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Jennifer M Washington Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535241600000",
    "number": "1174004329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17521 US HIGHWAY 69 S",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035594",
            "telephone_number": "903-839-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 NEW COPELAND RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033955",
            "telephone_number": "855-840-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-26",
        "last_updated": "2018-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2075603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WASHINGTON",
            "middle_name": "M",
            "prefix": "MRS.",
            "credential": "PTA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sumar Warren
• Regenia Washington-Redmon, NP
• Antoine Washington, MD
• Brittany Washington
• Fermond Leon Washington, OT
• Latrece Washington, LVN
• Robin Washington
• Joseph Soliman Wassef, M.D., P.C.
• James Louis Wasson, MD, FACOG
• Amy Waters, LPC

• Physical Therapy Assistant in Tyler, TX
• Providers in Tyler, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2018; 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.