Active NPI
Jibi Jacob
- Orthopedic Physical Therapist
- Mesquite, TX
National Provider Identifier
1437558012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 1248729
- Practice address
- 1650 Republic Pkwy Ste 103
Mesquite, TX 75150-6926 - Phone
- (972) 698-1140
- Fax
- (972) 681-8753
- NPI assigned
- Aug 19, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 1248729 | TX | Primary |
Addresses
Primary practice location
1650 Republic Pkwy Ste 103
Mesquite, TX 75150-6926
Mailing address
1650 Republic Pkwy Ste 103
Mesquite, TX 75150-6926
Phone (972) 698-1140
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1248729 | TX | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408406400000",
"number": "1437558012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 REPUBLIC PKWY STE 103",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751506926",
"telephone_number": "972-698-1140",
"fax_number": "972-681-8753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 REPUBLIC PKWY STE 103",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751506926",
"telephone_number": "972-698-1140",
"fax_number": "972-681-8753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "JIBI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-19",
"last_updated": "2014-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "TX",
"license": "1248729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesquite, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.