Jovencio Jimenez III, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT25149 Issued in CA

Practice address

1415 E Colorado St
Glendale, CA 91205-1533

Phone

(818) 240-5512

NPI assigned

Jul 17, 2006

Sex

Male

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 CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advance Therapy Physical Therapy Clinic, Inc

  • Physical Therapist
  • Glendale, CA
  • NPI 1538192695
  Medicare reassignment NPD

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407874720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2129 N BUENA VISTA ST",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915043307",
            "telephone_number": "818-955-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E COLORADO ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051533",
            "telephone_number": "818-240-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "JOVENCIO",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haixia Jiang
• Cynthia E Jimenez
• Cynthia Isabel Jimenez
• Jade Jimenez
• Jonathan Jimenez, DO
• Susana Jimenez
• Syuzanna Jinanyan, NP
• Jittima Jirasetpatana, D.P.M.
• Jittima Jirasetpatana
• Jivan Melikian M D. Inc

• Physical Therapist in Glendale, CA
• Providers in Glendale, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.