Individual provider Active NPI

Jessica Williman, PT

  • Physical Therapist
  • Arroyo Grande, CA
National Provider Identifier
1720454333
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT42826 Issued in CA
Practice address
1510 W Branch St
Arroyo Grande, CA 93420-1817
Phone
(805) 489-7912
Fax
(805) 489-9697
NPI assigned
Aug 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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 PT42826 CA Primary

Addresses

Primary practice location

1510 W Branch St
Arroyo Grande, CA 93420-1817

Mailing address

1106 Walnut St
Suite 110
San Luis Obispo, CA 93401-2416
Phone (805) 788-0805

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
42826CAMDMarriage & Family Therapist
PT42826CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
San Luis Physical Therapy & Orthopedic Rehabilitation Inc Physical Therapist PastSince Aug 17, 2015 Accepting new patients
San Luis Physical Therapy & Orthopedic Rehabilitation Inc Physical Therapist Past Accepting new patients

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": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1720454333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 WALNUT ST",
            "address_2": "SUITE 110",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012416",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 W BRANCH ST",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934201817",
            "telephone_number": "805-489-7912",
            "fax_number": "805-489-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIMAN",
        "first_name": "JESSICA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT42826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arroyo Grande, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.