Individual provider Active NPI

Myra Hizola Caang, PT

  • Physical Therapist
  • Jonesboro, AR
National Provider Identifier
1861456014
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2605 Issued in AR
Practice address
300 Waverly CV
Jonesboro, AR 72404-9490
Phone
(870) 740-2175
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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 PT2605 AR Primary

Addresses

Primary practice location

300 Waverly CV
Jonesboro, AR 72404-9490

Mailing address

300 Waverly CV
Jonesboro, AR 72404-9490
Phone (870) 740-2175

Other identifiers 2

IdentifierTypeStateIssuer
5W948OtherARBCBS INDIV. PROVIDER #
146510721MedicaidAR

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
PT2605ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Just Move Therapy Solutions PLLC Physical Therapist CurrentSince Sep 5, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1861456014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WAVERLY CV",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049490",
            "telephone_number": "870-740-2175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WAVERLY CV",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049490",
            "telephone_number": "870-740-2175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAANG",
        "first_name": "MYRA",
        "middle_name": "HIZOLA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT2605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIV. PROVIDER #",
            "identifier": "5W948",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146510721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.