NPIMap

Organization Active NPI

JTBL LLC

  • General Practice Physician
  • Gilbert, AZ
National Provider Identifier
1356905285
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
JTBL LLC
Practice address
3303 E Baseline Rd
Gilbert, AZ 85234-2738
Phone
(480) 331-1745
NPI assigned
Apr 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Trevor Ferguson
Title
Owner
Phone
(480) 331-1745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

3303 E Baseline Rd
Gilbert, AZ 85234-2738

Mailing address

2487 S Gilbert Rd Ste 106-133
Gilbert, AZ 85295-2805
Phone (480) 331-1745

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1356905285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2487 S GILBERT RD STE 106-133",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952805",
            "telephone_number": "480-331-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 E BASELINE RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342738",
            "telephone_number": "480-331-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JTBL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-331-1745"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.