Active NPI
Emmanuel B John, PT, DPT, PHD, MBA
- Physical Therapist
- Irvine, CA
National Provider Identifier
1689182123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTL.0013170
- Practice address
- 9401 Jeronimo Rd
Irvine, CA 92618-1908 - Phone
- (714) 744-7906
- Fax
- (949) 206-0119
- NPI assigned
- Jan 18, 2018
- Sex
- Male
- 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 | PTL.0013170 | CO | Primary |
Addresses
Primary practice location
9401 Jeronimo Rd
Irvine, CA 92618-1908
Mailing address
59 Eaglecreek
Irvine, CA 92618-3954
Phone (913) 963-9492
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
- Credentials
- Master of Business Administration, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL.0013170 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516233600000",
"number": "1689182123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "59 EAGLECREEK",
"city": "IRVINE",
"state": "CA",
"postal_code": "926183954",
"telephone_number": "913-963-9492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9401 JERONIMO RD",
"city": "IRVINE",
"state": "CA",
"postal_code": "926181908",
"telephone_number": "714-744-7906",
"fax_number": "949-206-0119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHN",
"first_name": "EMMANUEL",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "PT, DPT, PHD, MBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-18",
"last_updated": "2018-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "PTL.0013170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.