Active NPI
Jaclynn Thomas
- Physical Therapist
- Rockville, MD
National Provider Identifier
1710274196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT021474
- Practice address
- 2401 Research Blvd
Suite 109
Rockville, MD 20850-3215 - Phone
- (724) 859-0185
- NPI assigned
- Jul 6, 2011
- Last updated
- May 24, 2021
- Sex
- Female
- 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 | PT021474 | PA | Primary |
Addresses
Primary practice location
2401 Research Blvd
Suite 109
Rockville, MD 20850-3215
Mailing address
103 Mohawk St
Suite 200
Kittanning, PA 16201-3329
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | upmchospitals@upmcdirect.com | UPMC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT021474 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1710274196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 MOHAWK ST",
"address_2": "SUITE 200",
"city": "KITTANNING",
"state": "PA",
"postal_code": "162013329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 RESEARCH BLVD",
"address_2": "SUITE 109",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208503215",
"telephone_number": "724-859-0185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "JACLYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-06",
"last_updated": "2021-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT021474",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "upmchospitals@upmcdirect.com",
"affiliation": "Y",
"affiliationName": "UPMC",
"address_1": "600 Grant St",
"address_2": "Floor 58",
"city": "Pittsburgh",
"state": "PA",
"country_code": "US",
"postal_code": "152192702",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.