Jim Jiro Eddow, PT, DPT, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT29126 Issued in CA

Practice address

2815 S Main St Ste 205
Corona, CA 92882

Phone

(951) 475-1307

Fax

(951) 475-1308

NPI assigned

Dec 1, 2005

Last updated

Nov 7, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

All Star Physical TherapyGroup PAC ID 7719030949, 149 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

• All Star Physical Therapy

  • Physical Therapist
  • Temecula, CA
  • NPI 1750559431
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1578547683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 S MAIN ST STE 205",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822533",
            "telephone_number": "951-475-1307",
            "fax_number": "951-475-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 S MAIN ST STE 205",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92882",
            "telephone_number": "951-475-1307",
            "fax_number": "951-475-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDOW",
        "first_name": "JIM",
        "middle_name": "JIRO",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29126",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "29126",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miriam Echeverria
• Echo Waves Inc
• Louis Echols
• Eclipse Medical Group
• Christine Marie Eddow, PT DPT OCS WCS CHT
• Eliza Marie Edejer
• Cianna Edge, M.S., LMFT
• Loren Edry
• Megan Edwards
• Abigail Marie Egger

• Physical Therapist in Corona, CA
• Providers in Corona, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.