Active NPI
Jason Williams, PTA, NSCA-CPT
- Physical Therapy Assistant
- Aurora, IL
National Provider Identifier
1588936363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160004341
- Practice address
- 4215 Landing Dr
2C
Aurora, IL 60504-5017 - Phone
- (224) 688-4040
- NPI assigned
- Feb 8, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 7173161008 | CO | |
| Physical Therapy Assistant | 225200000X | 160004341 | IL | Primary |
Addresses
Primary practice location
4215 Landing Dr
2C
Aurora, IL 60504-5017
Mailing address
4215 Landing Dr
2C
Aurora, IL 60504-5017
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7173161008 | CO | MD | Specialist |
| 160004341 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328659200000",
"number": "1588936363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4215 LANDING DR",
"address_2": "2C",
"city": "AURORA",
"state": "IL",
"postal_code": "605045017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4215 LANDING DR",
"address_2": "2C",
"city": "AURORA",
"state": "IL",
"postal_code": "605045017",
"telephone_number": "224-688-4040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JASON",
"credential": "PTA, NSCA-CPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-08",
"last_updated": "2012-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CO",
"license": "7173161008",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160004341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.