Individual provider Active NPI

Jerry Lynn Hopper, RPT

  • Physical Therapist
  • Barstow, CA
National Provider Identifier
1629014063
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT13643 Issued in CA
Practice address
1815 E Main St
Barstow, CA 92311-3234
Phone
(760) 256-2800
Fax
(760) 256-2809
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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 PT13643 CA Primary

Addresses

Primary practice location

1815 E Main St
Barstow, CA 92311-3234

Mailing address

1815 E Main St
Barstow, CA 92311-3234
Phone (760) 256-2800

Other identifiers 1

IdentifierTypeStateIssuer
PT13643OtherCAPHYSICAL THERAPY LICENSE

Other names 1

  • Mr. Jerry L. Hopper Professional name

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
PT13643CAMDPhysical Therapist
1234CAMDPrevention Professional

Practice roles

OrganizationSpecialtyStatusNew patients
P and a Health Services Physical Therapist CurrentSince Mar 1, 2009 Accepting new patients
RPM Rebah, Inc Physical Therapist Past Accepting new patients
PT Plus Rehab, Inc Physical Therapist PastSince Mar 1, 2009 Accepting new patients

Locations

24 Hammond
Ste C
Irvine, CA 92618
Phone (949) 770-6022

14566 Seventh St
Victorville, CA 92395
Phone (760) 843-0895

Organizations & group practices 3

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1629014063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 E MAIN ST",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923113234",
            "telephone_number": "760-256-2800",
            "fax_number": "760-256-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 E MAIN ST",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923113234",
            "telephone_number": "760-256-2800",
            "fax_number": "760-256-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPPER",
        "first_name": "JERRY",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT13643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT13643",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERRY",
            "last_name": "HOPPER",
            "middle_name": "L.",
            "prefix": "MR.",
            "credential": "PT B.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Barstow, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.