Jeffrey Joseph Cervenka

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1327562 Issued in TX

Practice address

2421 Ira E Woods Ave #101
Grapevine, TX 76051

Phone

(817) 410-7773

NPI assigned

Feb 12, 2020

Last updated

Feb 12, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1881227346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 IRA E WOODS AVE #101",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "76051",
            "telephone_number": "817-410-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 IRA E WOODS AVE #101",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "76051",
            "telephone_number": "817-410-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVENKA",
        "first_name": "JEFFREY",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1327562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Justin Chan, M. D.
• Jacob Allen Chandler, DDS
• Kelli Chandler, DPT
• Sachi Chandran, APRN, FNP-C
• Doris H Chao, O.D.

• Physical Therapist in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.