Active NPI
Jorge A Negrete III, DPT
- Physical Therapist
- Springdale, AR
National Provider Identifier
1306203377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT4080
- Practice address
- 105 S Blair St
Springdale, AR 72764-4410 - Phone
- (479) 259-2339
- NPI assigned
- Jan 21, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT4080 | AR | Primary |
Addresses
Primary practice location
105 S Blair St
Springdale, AR 72764-4410
Mailing address
1630 N Merion Way
Apt 105
Fayetteville, AR 72704-6501
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT4080 | AR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Spot LLC | Physical Therapist | Past | 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": "1453334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453334400000",
"number": "1306203377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1630 N MERION WAY",
"address_2": "APT 105",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727046501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 S BLAIR ST",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727644410",
"telephone_number": "479-259-2339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEGRETE",
"first_name": "JORGE",
"middle_name": "A",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-01-21",
"last_updated": "2016-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "PT4080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.