Active NPI
Jimmy Enomoto, DPT
- Physical Therapist
- Naperville, IL
National Provider Identifier
1316425820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 4003 S Route 59
Naperville, IL 60564 - Phone
- (630) 967-2000
- NPI assigned
- Aug 6, 2018
- 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 | Primary |
Addresses
Primary practice location
4003 S Route 59
Naperville, IL 60564
Mailing address
1860 Paysphere Cir
Chicago, IL 60674-0018
Phone (630) 469-2000
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jenomoto172882@direct.edward.org | ||
| Direct Messaging Address | jenomoto172882@dulyhealthandcare.direct-ci.com |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655424000000",
"number": "1316425820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 PAYSPHERE CIR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606740018",
"telephone_number": "630-469-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4003 S ROUTE 59",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "60564",
"telephone_number": "630-967-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENOMOTO",
"first_name": "JIMMY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-06",
"last_updated": "2022-06-17",
"certification_date": "2022-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jenomoto172882@direct.edward.org",
"affiliation": "N",
"address_1": "4003 S Route 59",
"city": "Naperville",
"state": "IL",
"country_code": "US",
"postal_code": "60564",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jenomoto172882@dulyhealthandcare.direct-ci.com",
"affiliation": "N",
"address_1": "4003 S Route 59",
"city": "Naperville",
"state": "IL",
"country_code": "US",
"postal_code": "60564",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.