Individual provider Active NPI

Jennifer Leigh Mellinger, DPT

  • Physical Therapist
  • Temecula, CA
National Provider Identifier
1780005793
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT40800 Issued in CA
Practice address
28780 Single Oak Dr
Ste. 290
Temecula, CA 92590-3625
Phone
(951) 693-5871
Fax
(951) 693-5872
NPI assigned
Dec 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

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 PT40800 CA Primary

Addresses

Primary practice location

28780 Single Oak Dr
Ste. 290
Temecula, CA 92590-3625

Mailing address

24630 Washington Ave
Ste. 200
Murrieta, CA 92562-6131
Phone (951) 696-9353

Other names 1

  • Jennifer Leigh Gebhardt Other 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
PT40800CAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1780005793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24630 WASHINGTON AVE",
            "address_2": "STE. 200",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925626131",
            "telephone_number": "951-696-9353",
            "fax_number": "951-973-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28780 SINGLE OAK DR",
            "address_2": "STE. 290",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925903625",
            "telephone_number": "951-693-5871",
            "fax_number": "951-693-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLINGER",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-17",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT40800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GEBHARDT",
            "middle_name": "LEIGH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; 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.