Individual provider Active NPI

Jessica Martin

  • Physical Therapist
  • Rancho Santa Margarita, CA
National Provider Identifier
1316570781
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
297749 Issued in CA
Practice address
29811 Santa Margarita Pkwy
Rancho Santa Margarita, CA 92688-3612
Phone
(949) 600-5437
NPI assigned
Feb 13, 2020
Last updated
Feb 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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 297749 CA Primary

Addresses

Primary practice location

29811 Santa Margarita Pkwy
Rancho Santa Margarita, CA 92688-3612

Mailing address

22431 Antonio Pkwy Ste B160-493
RSM, CA 92688-2804
Phone (949) 528-5400

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

LicenseStateTypeSpecialty
297749CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Hailey Mayz Foundation CurrentSince Feb 16, 2020 Accepting new patients

Locations

22431 Antonio Pkwy
Ste B160493
Rsm, CA 92688
Phone (949) 600-5437

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1316570781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22431 ANTONIO PKWY STE B160-493",
            "city": "RSM",
            "state": "CA",
            "postal_code": "926882804",
            "telephone_number": "949-528-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29811 SANTA MARGARITA PKWY",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883612",
            "telephone_number": "949-600-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.