Individual provider Active NPI

Jeremy Wampler, DPT

  • Specialist
  • Beaumont, CA
National Provider Identifier
1265845978
Registry record updated Jun 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
39326 Issued in CA
Practice address
1676 E 6TH St
Suite C
Beaumont, CA 92223-5760
Phone
(951) 769-0300
Fax
(951) 769-2811
NPI assigned
Jun 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 39326 CA Primary

Addresses

Primary practice location

1676 E 6TH St
Suite C
Beaumont, CA 92223-5760

Mailing address

1676 E 6TH St
Suite C
Beaumont, CA 92223-5760
Phone (951) 769-0300

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
39326CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Adorador Enterprises Inc PastSince Jul 1, 2002 Accepting new patients

Organizations & group practices 1

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": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1265845978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1676 E 6TH ST",
            "address_2": "SUITE C",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922235760",
            "telephone_number": "951-769-0300",
            "fax_number": "951-769-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1676 E 6TH ST",
            "address_2": "SUITE C",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922235760",
            "telephone_number": "951-769-0300",
            "fax_number": "951-769-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAMPLER",
        "first_name": "JEREMY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "39326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.