Justin Lance Fields, PTA, BS

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2138895 Issued in TX

Practice address

406 S Main St
Winnsboro, TX 75494-3226

Phone

(903) 342-6790

NPI assigned

Jul 23, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1194202275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 E HAWKINS PKWY APT 6304",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756058143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 S MAIN ST",
            "city": "WINNSBORO",
            "state": "TX",
            "postal_code": "754943226",
            "telephone_number": "903-342-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "JUSTIN",
        "middle_name": "LANCE",
        "credential": "PTA, BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2138895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Winnsboro, TX
• Providers in Winnsboro, 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 Jul 23, 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.