Jennifer Celine Wu Medina, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1249060 Issued in TX

Practice address

404 W Goodwin St
Pleasanton, TX 78064

Phone

(830) 569-2138

NPI assigned

Aug 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Celine Wu Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jennifer.celine.wu-medina.1@17371.direct.athenahealth.com

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1215416938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13730 ASTROS LN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782453298",
            "telephone_number": "210-621-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W GOODWIN ST",
            "city": "PLEASANTON",
            "state": "TX",
            "postal_code": "78064",
            "telephone_number": "830-569-2138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1855 W Goodwin St",
            "address_purpose": "LOCATION",
            "city": "Pleasanton",
            "state": "TX",
            "postal_code": "780644502",
            "country_code": "US",
            "telephone_number": "830-281-8202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "JENNIFER CELINE",
        "middle_name": "WU",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CA",
            "license": "297723",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1249060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER CELINE",
            "last_name": "WU",
            "credential": "RPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maverick County Hospital District
• Maverick County Hospital District
• McCrae Management and Investments, LTD.
• McMullen Isd
• Ashley Marie McPhail
• Melanie Elizabeth Meier, MA LPC
• Mercedes Iturralde Mendez
• Chelsea Dawn Meyer, RDH
• Kyle Middleton
• Laura P Mireles, P.A.

• Physical Therapist in Pleasanton, TX
• Providers in Pleasanton, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.