Individual provider Active NPI

Jacqueline V Williams-Rahman, LPTA

  • Physical Therapy Assistant
  • Mansfield, TX
National Provider Identifier
1821622671
Registry record updated Mar 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2031235 Issued in TX
Practice address
10 Pinedale CT
Mansfield, TX 76063-5583
Phone
(682) 465-4959
NPI assigned
Mar 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2031235 TX Primary

Addresses

Primary practice location

10 Pinedale CT
Mansfield, TX 76063-5583

Mailing address

10 Pinedale CT
Mansfield, TX 76063-5583
Phone (682) 465-4959

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

LicenseStateTypeSpecialty
2031235TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1583020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583020800000",
    "number": "1821622671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PINEDALE CT",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635583",
            "telephone_number": "682-465-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PINEDALE CT",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635583",
            "telephone_number": "682-465-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS-RAHMAN",
        "first_name": "JACQUELINE",
        "middle_name": "V",
        "name_prefix": "Prof.",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-01",
        "last_updated": "2020-03-01",
        "certification_date": "2020-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2031235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.

Verify at the official NPI Registry.