Active NPI
Jason Graham
- Physical Therapist
- Fort Worth, TX
National Provider Identifier
1336513167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1264458
- Practice address
- 2720 Western Center Blvd
Suite 312
Fort Worth, TX 76131-4302 - Phone
- (817) 847-0200
- NPI assigned
- Nov 17, 2015
- 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 | 1264458 | TX | Primary |
Addresses
Primary practice location
2720 Western Center Blvd
Suite 312
Fort Worth, TX 76131-4302
Mailing address
10304 Grayhawk LN
Fort Worth, TX 76244-8543
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": "1447718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447718400000",
"number": "1336513167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10304 GRAYHAWK LN",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762448543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2720 WESTERN CENTER BLVD",
"address_2": "SUITE 312",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761314302",
"telephone_number": "817-847-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-17",
"last_updated": "2015-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1264458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.