Individual provider Active NPI

Jessica Edwards, PT, DPT

  • Physical Therapist
  • Burbank, CA
National Provider Identifier
1255646295
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 32557 Issued in CA
Practice address
711 E Palm Ave Apt C
Burbank, CA 91501
Phone
(323) 430-7954
NPI assigned
Aug 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 32557 CA Primary

Addresses

Primary practice location

711 E Palm Ave Apt C
Burbank, CA 91501

Mailing address

711 E Palm Ave Apt C
Burbank, CA 91501-2142
Phone (323) 430-7954

Other practice location 1

1545 W Florida Avenue
Suite E
Hemet, CA 92543-3817
Phone (951) 658-3121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101026001251 CA Practitioner - Physical Therapist in Private Practice 5991998676 Reassigns benefits to 1 organization
Practice locations: Burbank, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32557CAMDGeneral Practice Dentistry
PT 32557CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jul 12, 2024 Accepting new patients
Transformational Life Care LLC Current Accepting new patients
Applied Therapy Solutions, LLC Physical Therapist PastSince Feb 26, 2020 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1281744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1255646295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 E PALM AVE APT C",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915012142",
            "telephone_number": "323-430-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E PALM AVE APT C",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "91501",
            "telephone_number": "323-430-7954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1545 W Florida Avenue",
            "address_2": "Suite E",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925433817",
            "country_code": "US",
            "telephone_number": "951-658-3121",
            "fax_number": "951-652-6994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JESSICA",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-14",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 32557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.