Jonathan Reed Packer, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

006771 Issued in KY

Practice address

165 Natchez Trace Ave
Suite 200
Bowling Green, KY 42103-7940

Phone

(270) 796-4698

Fax

(270) 782-3274

NPI assigned

Jan 6, 2016

Last updated

Jan 6, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1205292257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5629",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477165629",
            "telephone_number": "812-759-7451",
            "fax_number": "812-759-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 NATCHEZ TRACE AVE",
            "address_2": "SUITE 200",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037940",
            "telephone_number": "270-796-4698",
            "fax_number": "270-782-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKER",
        "first_name": "JONATHAN",
        "middle_name": "REED",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "006771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; 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.