NPIMap

Organization Active NPI

Proactive Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Pataskala, OH
National Provider Identifier
1881963353
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT7033 Issued in OH
Legal business name
PROACTIVE PHYSICAL THERAPY LLC
Practice address
580 E Broad St
Pataskala, OH 43062-7570
Phone
(740) 971-8344
Fax
(740) 965-6326
NPI assigned
Dec 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Authorized official

Name
Dr. James E Jenkins, PH.D., P.T.NPI 1073625604
Title
Owner
Phone
(740) 971-8344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT7033 OH Primary

Addresses

Primary practice location

580 E Broad St
Pataskala, OH 43062-7570

Mailing address

11761 Trenton Rd
Galena, OH 43021-9511
Phone (740) 971-8344

National Provider Directory

National Provider Directory

Locations

580 E Broad St
Pataskala, OH 43062
Phone (740) 971-8344

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325116800000",
    "number": "1881963353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11761 TRENTON RD",
            "city": "GALENA",
            "state": "OH",
            "postal_code": "430219511",
            "telephone_number": "740-971-8344",
            "fax_number": "740-965-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 E BROAD ST",
            "city": "PATASKALA",
            "state": "OH",
            "postal_code": "430627570",
            "telephone_number": "740-971-8344",
            "fax_number": "740-965-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-29",
        "last_updated": "2011-12-29",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-971-8344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OH",
            "license": "PT7033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pataskala, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; 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.