Active NPI
Gregory Meyer
- Pediatric Physical Therapist
- Jacksonville, AR
National Provider Identifier
1467817239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PTA1910
- Practice address
- 2701 T P White Dr
Jacksonville, AR 72076-2514 - Phone
- (501) 241-0410
- NPI assigned
- Dec 22, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PTA1910 | AR | Primary |
Addresses
Primary practice location
2701 T P White Dr
Jacksonville, AR 72076-2514
Mailing address
23 Red Bird CV
Cabot, AR 72023-7048
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 225200000X | Other | AR | PTA TAXONOMY NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA1910 | AR | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450742400000",
"number": "1467817239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 RED BIRD CV",
"city": "CABOT",
"state": "AR",
"postal_code": "720237048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 T P WHITE DR",
"city": "JACKSONVILLE",
"state": "AR",
"postal_code": "720762514",
"telephone_number": "501-241-0410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEYER",
"first_name": "GREGORY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-22",
"last_updated": "2015-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "AR",
"license": "PTA1910",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTA TAXONOMY NUMBER",
"identifier": "225200000X",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.