Individual provider Active NPI

Jennifer Salazar Pido, PT

  • Physical Therapist
  • Danville, IL
National Provider Identifier
1407093594
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070015782 Issued in IL
Practice address
14792 Catlin Tilton Rd
Danville, IL 61834-5116
Phone
(217) 443-6430
Fax
(217) 443-1558
NPI assigned
Jan 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070015782 IL Primary
Physical Therapist 225100000X 2006023687 MO

Addresses

Primary practice location

14792 Catlin Tilton Rd
Danville, IL 61834-5116

Mailing address

214 W 5TH St
Ste D & E
Joplin, MO 64801-2501
Phone (417) 782-2917

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070015782ILMDPhysical Therapist
2006023687MOMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231718400000",
    "number": "1407093594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 W 5TH ST",
            "address_2": "STE D & E",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648012501",
            "telephone_number": "417-782-2917",
            "fax_number": "417-782-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14792 CATLIN TILTON RD",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618345116",
            "telephone_number": "217-443-6430",
            "fax_number": "217-443-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIDO",
        "first_name": "JENNIFER",
        "middle_name": "SALAZAR",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070015782",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2006023687",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; 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.