Individual provider Active NPI

Jordan Lynn McNeil

  • Physical Therapy Assistant
  • Taylor, TX
National Provider Identifier
1477034767
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2091003 Issued in TX
Practice address
1810 Old Granger
Taylor, TX 76574-3564
Phone
(512) 352-6337
NPI assigned
Aug 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2091003 TX Primary

Addresses

Primary practice location

1810 Old Granger
Taylor, TX 76574-3564

Mailing address

105 Lucky Clover LN
Hutto, TX 78634-4174
Phone (512) 665-5305

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
2091003TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1477034767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 LUCKY CLOVER LN",
            "city": "HUTTO",
            "state": "TX",
            "postal_code": "786344174",
            "telephone_number": "512-665-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 OLD GRANGER",
            "city": "TAYLOR",
            "state": "TX",
            "postal_code": "765743564",
            "telephone_number": "512-352-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEIL",
        "first_name": "JORDAN",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2091003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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.