Individual provider Active NPI

Loyd Jerald Jeffers, DPT

  • Physical Therapist
  • Palestine, TX
National Provider Identifier
1558496505
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1166553 Issued in TX
Practice address
3201 S Loop 256 Ste 400
Palestine, TX 75801
Phone
(903) 723-1475
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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 1166553 TX Primary

Addresses

Primary practice location

3201 S Loop 256 Ste 400
Palestine, TX 75801

Mailing address

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3400

Other identifiers 4

IdentifierTypeStateIssuer
P02142307OtherTXMEDICARE RAIL ROAD
391810401MedicaidTX
738291OtherTXMEDICARE
8KC689OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181204000961 TX Practitioner - Physical Therapist in Private Practice 7911241807 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Sep 4, 2018 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 4, 2018 Accepting new patients

Locations

3201 S Loop 256
Ste 400
Palestine, TX 75801
Phone (903) 661-7179

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Organizations & group practices 2

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1558496505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 HARTFORD ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796054603",
            "telephone_number": "325-793-3400",
            "fax_number": "325-793-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 S LOOP 256 STE 400",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "75801",
            "telephone_number": "903-723-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERS",
        "first_name": "LOYD",
        "middle_name": "JERALD",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1166553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P02142307",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "391810401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "738291",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8KC689",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.