Active NPI
Jamie Lyn Tan
- Physical Therapist
- Laguna Niguel, CA
National Provider Identifier
1790382687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 299183
- Practice address
- 30025 Alicia Pkwy
Laguna Niguel, CA 92677-2090 - Phone
- (714) 281-0169
- NPI assigned
- Oct 5, 2020
- Last updated
- Oct 5, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 299183 | CA | Primary |
Addresses
Primary practice location
30025 Alicia Pkwy
Laguna Niguel, CA 92677-2090
Mailing address
1471 Mulville St
Fullerton, CA 92833-5653
Phone (714) 504-6818
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JM Physical Therapy Inc | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601856000000",
"number": "1790382687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1471 MULVILLE ST",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928335653",
"telephone_number": "714-504-6818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30025 ALICIA PKWY",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926772090",
"telephone_number": "714-281-0169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "JAMIE",
"middle_name": "LYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-05",
"last_updated": "2020-10-05",
"certification_date": "2020-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "299183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laguna Niguel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.