Individual provider Active NPI

Jamie Naab

  • Physical Therapist
  • Evans, GA
National Provider Identifier
1215318514
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011952 Issued in GA
Practice address
400 Town Park Blvd
Suite 100
Evans, GA 30809-3471
Phone
(706) 854-9850
NPI assigned
Jun 11, 2015
Last updated
Jul 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305209501 VA
Physical Therapist 225100000X PT011952 GA Primary

Addresses

Primary practice location

400 Town Park Blvd
Suite 100
Evans, GA 30809-3471

Mailing address

400 Town Park Blvd
Suite 100
Evans, GA 30809-3471
Phone (706) 854-9850

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT011952GAMDPhysical Therapist
2305209501VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1215318514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 TOWN PARK BLVD",
            "address_2": "SUITE 100",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093471",
            "telephone_number": "706-854-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TOWN PARK BLVD",
            "address_2": "SUITE 100",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093471",
            "telephone_number": "706-854-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAAB",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305209501",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.