Individual provider Active NPI

John Bob, D.P.T.

  • Orthopedic Physical Therapist
  • Stockton, CA
National Provider Identifier
1720163249
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
23523 Issued in CA
Practice address
10200 Trinity Pkwy
Suite 205
Stockton, CA 95219-7286
Phone
(209) 451-3920
Fax
(209) 451-3902
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 23523 CA Primary

Addresses

Primary practice location

10200 Trinity Pkwy
Suite 205
Stockton, CA 95219-7286

Mailing address

534 E Pine St
Suite a
Stockton, CA 95204-5536
Phone (209) 463-5800

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

Practice roles

OrganizationSpecialtyStatusNew patients
JBJC Inc. Orthopedic CurrentSince Aug 12, 2002 Accepting new patients
JBJC Inc CurrentSince Feb 4, 2002 Accepting new patients

Locations

534 E Pine St
Ste A
Stockton, CA 95204
Phone (209) 463-5800

10200 Trinity Pkwy
Ste 205
Stockton, CA 95219
Phone (209) 451-3920

Organizations & group practices 2

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1720163249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 E PINE ST",
            "address_2": "SUITE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045536",
            "telephone_number": "209-463-5800",
            "fax_number": "209-463-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 TRINITY PKWY",
            "address_2": "SUITE 205",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952197286",
            "telephone_number": "209-451-3920",
            "fax_number": "209-451-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOB",
        "first_name": "JOHN",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "23523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.