Active NPI
Jordan Fox
- Physical Therapist
- Southlake, TX
National Provider Identifier
1538697180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1290797
- Practice address
- 731 E Southlake Blvd Ste 150
Southlake, TX 76092-6380 - Phone
- (817) 442-8600
- Fax
- (817) 442-8603
- NPI assigned
- May 26, 2017
- Sex
- Female
- 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 | 1290797 | TX | Primary |
Addresses
Primary practice location
731 E Southlake Blvd Ste 150
Southlake, TX 76092-6380
Mailing address
966 N Garden Ridge Blvd
Ste 530
Lewisville, TX 75077-2876
Phone (972) 420-6605
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": "1495756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1538697180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "966 N GARDEN RIDGE BLVD",
"address_2": "STE 530",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750772876",
"telephone_number": "972-420-6605",
"fax_number": "844-965-9627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "731 E SOUTHLAKE BLVD STE 150",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926380",
"telephone_number": "817-442-8600",
"fax_number": "817-442-8603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOX",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-26",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1290797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.