Active NPI
Jacquline O'Neal
- Physical Therapy Assistant
- Greenville, TX
National Provider Identifier
1477759504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2061750
- Practice address
- 3201 Kari LN
Apt 1722
Greenville, TX 75402-7200 - Phone
- (903) 408-1886
- NPI assigned
- Jun 25, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2061750 | TX | Primary |
Addresses
Primary practice location
3201 Kari LN
Apt 1722
Greenville, TX 75402-7200
Mailing address
4006 Shady Oak Dr
Ooltewah, TN 37363-7012
Phone (423) 903-5918
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 |
|---|---|---|---|
| 2061750 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477759504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4006 SHADY OAK DR",
"city": "OOLTEWAH",
"state": "TN",
"postal_code": "373637012",
"telephone_number": "423-903-5918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 KARI LN",
"address_2": "APT 1722",
"city": "GREENVILLE",
"state": "TX",
"postal_code": "754027200",
"telephone_number": "903-408-1886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'NEAL",
"first_name": "JACQULINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2061750",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, TX
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.