Jeanne Marie Santos Ubalde, PT, CLT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1210835 Issued in TX

Practice address

912 Walnut Hill Dr
Longview, TX 75605-5052

Phone

(903) 212-9456

Fax

(903) 291-6305

NPI assigned

Sep 6, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ryan M Guillory MD PAGroup PAC ID 1254608771, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ryan M Guillory MD PA

  • Otolaryngology Physician
  • Longview, TX
  • NPI 1184159055
  Medicare reassignment Care Compare group NPD
• U First Physical Therapy and Wellness PLLC

  • Physical Therapist
  • Longview, TX
  • NPI 1669287520
  NPD Authorized official

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1386126233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 WALNUT HILL DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055052",
            "telephone_number": "903-212-9456",
            "fax_number": "903-291-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 WALNUT HILL DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055052",
            "telephone_number": "903-212-9456",
            "fax_number": "903-291-6305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Horseshoe Ln",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756055650",
            "country_code": "US",
            "telephone_number": "903-234-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UBALDE",
        "first_name": "JEANNE MARIE",
        "middle_name": "SANTOS",
        "credential": "PT, CLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1210835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Twelve52 Wellness Clinic
• Tiffany Tyeskie, FNP-C
• Shanacia Tyiska
• U First Physical Therapy and Wellness PLLC
• Adelaido Parilla Ubalde Jr., PT
• Michelle Uhlir, RT (R)
• Ultra Orthodontics
• Sathiraju Undavalli, MD
• Stanley Upchurch, MD
• Kyle Patrick Urbanek

• Physical Therapist in Longview, TX
• Providers in Longview, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.

Verify at the official NPI Registry.