Active NPI
Jerrell Minor
- Physical Therapy Assistant
- Merced, CA
National Provider Identifier
1184321978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 50768
- Practice address
- 510 W 26TH St
Merced, CA 95340-2804 - Phone
- (209) 723-2911
- NPI assigned
- Feb 13, 2023
- Sex
- Male
- Sole proprietor
- No
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 Therapy Assistant | 225200000X | 50768 | CA | Primary |
Addresses
Primary practice location
510 W 26TH St
Merced, CA 95340-2804
Mailing address
930 Neal St
Los Banos, CA 93635-5205
Phone (209) 704-0711
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
| License | State | Type | Specialty |
|---|---|---|---|
| 50768 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1184321978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "930 NEAL ST",
"city": "LOS BANOS",
"state": "CA",
"postal_code": "936355205",
"telephone_number": "209-704-0711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 W 26TH ST",
"city": "MERCED",
"state": "CA",
"postal_code": "953402804",
"telephone_number": "209-723-2911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINOR",
"first_name": "JERRELL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-13",
"last_updated": "2023-02-13",
"certification_date": "2023-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "50768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merced, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.