Individual provider Active NPI

Jessica Amling, P.T.

  • Physical Therapist
  • Costa Mesa, CA
National Provider Identifier
1497984876
Registry record updated Jul 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT35754 Issued in CA
Practice address
230 E 17TH St
Suite 201
Costa Mesa, CA 92627-3824
Phone
(949) 631-0125
Fax
(714) 631-0127
NPI assigned
Jul 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2009

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 PT35754 CA Primary

Addresses

Primary practice location

230 E 17TH St
Suite 201
Costa Mesa, CA 92627-3824

Mailing address

230 E 17TH St
Suite 201
Costa Mesa, CA 92627-3824
Phone (949) 631-0125

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
PT35754CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Physical Therapy and Rehabilitation Inc Physical Therapist PastSince Oct 4, 2004 Accepting new patients

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": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246924800000",
    "number": "1497984876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E 17TH ST",
            "address_2": "SUITE 201",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273824",
            "telephone_number": "949-631-0125",
            "fax_number": "714-631-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E 17TH ST",
            "address_2": "SUITE 201",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273824",
            "telephone_number": "949-631-0125",
            "fax_number": "714-631-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMLING",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-07",
        "last_updated": "2009-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT35754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; 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.