Active NPI
Jillian Dickerson Bason, PT, DPT
- Physical Therapist
- Lubbock, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1294647
- Practice address
- 3838 50TH St
Lubbock, TX 79413 - Phone
- (806) 792-5522
- Fax
- (806) 785-7582
- NPI assigned
- Aug 30, 2017
- Last updated
- Jul 21, 2022
- Sex
- Female
- 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 | 1294647 | TX | Primary |
Addresses
Primary practice location
3838 50TH St
Lubbock, TX 79413
Mailing address
3838 50TH St
Lubbock, TX 79413-3808
Phone (806) 792-5522
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3838 50TH St
Lubbock, TX 79413-3808
Phone (806) 792-5522
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1294647 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grace Clinic of Lubbock | Current | Accepting new patients | |
| Physical Therapy Associates, LP | Physical Therapist | Current | Accepting new patients |
| Grace Clinic of Lubbock | Physical Therapist | Current | Accepting new patients |
Locations
3838 50th St
Lubbock, TX 79413
Phone (806) 792-5522
4515 Marsha Sharp Fwy
Lubbock, TX 79407
Phone 80674472232432
Organizations & group practices 3
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.
-
dba Grace Clinic
- Family Medicine Physician
- Lubbock, TX
- NPI 1912953357
Physical Therapist
-
- Physical Therapist
- Lubbock, TX
- NPI 1790890937
-
dba Expresscare Virtual
- Multi-Specialty Clinic/Center
- Lubbock, TX
- NPI 1770237042
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1336667344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3838 50TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794133808",
"telephone_number": "806-792-5522",
"fax_number": "806-785-7582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3838 50TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "79413",
"telephone_number": "806-792-5522",
"fax_number": "806-785-7582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASON",
"first_name": "JILLIAN",
"middle_name": "DICKERSON",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-30",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1294647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.