Individual provider Active NPI

Jessica G Monteleone, PT

  • Physical Therapist
  • Dothan, AL
National Provider Identifier
1487850608
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH8878 Issued in AL
Practice address
2323 W Main St Ste 109
Dothan, AL 36301-1287
Phone
(850) 267-9010
Fax
(850) 267-0677
NPI assigned
Jun 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH8878 AL Primary

Addresses

Primary practice location

2323 W Main St Ste 109
Dothan, AL 36301-1287

Mailing address

2323 W Main St
Ste 109
Dothan, AL 36301-1287
Phone (850) 835-6838

Other identifiers 1

IdentifierTypeStateIssuer
7446067OtherFLJESS'S AETNA PROVIDER#

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

LicenseStateTypeSpecialty
PTH8878ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Walton Physical Therapy and Rehabilitation, Inc Physical Therapist CurrentSince Sep 23, 1997 Accepting new patients

Locations

4942 US Highway 98 W
Ste 6
Santa Rosa Beach, FL 32459
Phone (850) 267-9010

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1661385600000",
    "number": "1487850608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 W MAIN ST",
            "address_2": "STE 109",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011287",
            "telephone_number": "850-835-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 W MAIN ST STE 109",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011287",
            "telephone_number": "850-267-9010",
            "fax_number": "850-267-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTELEONE",
        "first_name": "JESSICA",
        "middle_name": "G",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH8878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JESS'S AETNA PROVIDER#",
            "identifier": "7446067",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.