Jake Wood Putnam Bagley, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

292658 Issued in CA

Practice address

303 2ND St Ste 115C
San Francisco, CA 94107

Phone

(415) 498-0537

NPI assigned

Feb 12, 2015

Last updated

Dec 10, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jake.bagley@238098461884420.direct.elationemr.com

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1174914147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2556 47TH AVENUE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941213206",
            "telephone_number": "415-498-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 2ND ST STE 115C",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94107",
            "telephone_number": "415-498-0537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAGLEY",
        "first_name": "JAKE",
        "middle_name": "WOOD PUTNAM",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-12",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0012518",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Baggs, M.S.CCC-SLP
• Paniz Bagheri, CMT
• Alireza Bagherian, D.C.
• Wenelia Baghoomian, MD, MCR
• Bruce Joseph Baginski
• Shelley Bagley Bagley
• Justin Bagnall
• Gilbert Bagot
• Shannon Bagot, MD
• Manjot Bagri

• Physical Therapist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.