Active NPI
Jessica K Brown
- Physical Therapy Assistant
- Jacksonville, FL
National Provider Identifier
1790394948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA29830
- Practice address
- 8700 A C Skinner Pkwy
Jacksonville, FL 32256-0487 - Phone
- (904) 642-7300
- Fax
- (904) 641-7977
- NPI assigned
- Jul 23, 2020
- 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 Therapy Assistant | 225200000X | PTA29830 | FL | Primary |
Addresses
Primary practice location
8700 A C Skinner Pkwy
Jacksonville, FL 32256-0487
Mailing address
2264 S Brook Dr
Fleming Island, FL 32003-8610
Phone (770) 313-2852
Other practice location 1
7723 Jasper Ave
Jacksonville, FL 32211-7719
Phone (904) 725-8044
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA29830 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595462400000",
"number": "1790394948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2264 S BROOK DR",
"city": "FLEMING ISLAND",
"state": "FL",
"postal_code": "320038610",
"telephone_number": "770-313-2852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 A C SKINNER PKWY",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322560487",
"telephone_number": "904-642-7300",
"fax_number": "904-641-7977"
}
],
"practiceLocations": [
{
"address_1": "7723 Jasper Ave",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322117719",
"country_code": "US",
"telephone_number": "904-725-8044",
"fax_number": "319-390-4721",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROWN",
"first_name": "JESSICA",
"middle_name": "K",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-23",
"last_updated": "2020-07-23",
"certification_date": "2020-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA29830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.