Individual provider Active NPI

Jaclyn Meadows, PT

  • Physical Therapist
  • Hinesville, GA
National Provider Identifier
1366606899
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006699 Issued in GA
Practice address
512 S Main St
Hinesville, GA 31313-4325
Phone
(912) 368-4131
Fax
(912) 368-4132
NPI assigned
Jul 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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 PT006699 GA Primary

Addresses

Primary practice location

512 S Main St
Hinesville, GA 31313-4325

Mailing address

PO Box 2829
Richmond Hill, GA 31324-2829
Phone (912) 756-5699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121212000312 GA Practitioner - Physical Therapist in Private Practice 7911159249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
BCD Rehab and Fitness,LLCGroup PAC ID 1759690746, 11 clinicians

Practice addresses (Care Compare)

10144 Ford Ave
Richmond Hill, GA 31324-3936
Phone (912) 727-2321

PO Box
Suite 1272
Richmond Hill, GA 31324-3936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT006699GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
BCD Rehab & Fitness, LLC CurrentSince Jun 13, 2015 Accepting new patients
Scholar Rehab Physical Therapist Past Accepting new patients
West Rehab Services, Inc. Physical Therapist Past Accepting new patients

Locations

10144 Ford Ave
Richmond Hill, GA 31324
Phone (912) 727-2321

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1366606899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2829",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313242829",
            "telephone_number": "912-756-5699",
            "fax_number": "912-756-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 S MAIN ST",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134325",
            "telephone_number": "912-368-4131",
            "fax_number": "912-368-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEADOWS",
        "first_name": "JACLYN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT006699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.

Verify at the official NPI Registry.