Active NPI
Jeffrey Robert Geller, D.P.T.
- Physical Therapist
- Kingman, AZ
National Provider Identifier
1316351901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10539
- Practice address
- 3131 Western Ave
Kingman, AZ 86401-0951 - Phone
- (928) 718-0718
- NPI assigned
- Jun 11, 2014
- Last updated
- Jun 11, 2014
- Sex
- Male
- Sole proprietor
- No
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 | 10539 | AZ | Primary |
Addresses
Primary practice location
3131 Western Ave
Kingman, AZ 86401-0951
Mailing address
3131 Western Ave
Kingman, AZ 86401-0951
Phone (928) 718-0718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230622001850 | AZ | Practitioner - Physical Therapist in Private Practice | 9931567062 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10539 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402444800000",
"number": "1316351901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3131 WESTERN AVE",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864010951",
"telephone_number": "928-718-0718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3131 WESTERN AVE",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864010951",
"telephone_number": "928-718-0718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GELLER",
"first_name": "JEFFREY",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-11",
"last_updated": "2014-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "10539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingman, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.