Active NPI
Jerald L Starkey, PHYSICAL THERAPIST
- Physical Therapist
- Roseville, CA
National Provider Identifier
1487755468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7004
- Practice address
- 3100 Douglas Blvd
Suite 204
Roseville, CA 95661 - Phone
- (916) 772-7190
- Fax
- (916) 772-5510
- NPI assigned
- Sep 25, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7004 | CA | Primary |
Addresses
Primary practice location
3100 Douglas Blvd
Suite 204
Roseville, CA 95661
Mailing address
7175 Allen Lane
Penryn, CA 95663
Phone (916) 663-3811
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487755468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7175 ALLEN LANE",
"city": "PENRYN",
"state": "CA",
"postal_code": "95663",
"telephone_number": "916-663-3811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 DOUGLAS BLVD",
"address_2": "SUITE 204",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "95661",
"telephone_number": "916-772-7190",
"fax_number": "916-772-5510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARKEY",
"first_name": "JERALD",
"middle_name": "L",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "7004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
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.