Jacob Channing Pattengill, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

240 S Mount Auburn Rd
Cape Girardeau, MO 63703-4918

Phone

(573) 334-6711

NPI assigned

Nov 7, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Select Physical Therapy Holdings Inc

  • Rehabilitation Clinic/Center
  • Kansas City, MO
  • NPI 1033179510

  Physical Therapist

  Medicare reassignment NPD
• Select Physical Therapy Holdings, Inc.

  • Physical Therapy Clinic/Center
  • Parkville, MO
  • NPI 1831844885

  Physical Therapist

  NPD
• Select Physical Therapy Holdings Inc

  • Physical Therapy Clinic/Center
  • Ashland, VA
  • NPI 1174591218
  NPD
• Prorehab PC

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1538119409
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1194894980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 SUE ANNE TRAIL",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "63701",
            "telephone_number": "573-334-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034918",
            "telephone_number": "573-334-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTENGILL",
        "first_name": "JACOB",
        "middle_name": "CHANNING",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "2002029012",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kunal Pradip Patel, M.D.
• Nimesh Vinod Patel, M.D
• Sagar Chandravadan Patel, M.D.
• Michelle Renee Patrick, PH.D.
• Sarah Elizabeth Patrick, LPC
• Regina Renee Pattengill, MA CCC-SLP
• Ariese Patterson
• Mary Kathleen Patterson, LPC
• Morgan Makayla Patterson
• Jeffrey Dean Patton, D.D.S.

• Physical Therapist in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.