Individual provider Active NPI

Jessica Mehsikomer, PTA

  • Physical Therapy Assistant
  • Coral Springs, FL
National Provider Identifier
1902160427
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A-1341 Issued in NM
Practice address
5830 Coral Ridge Dr Ste 300
Coral Springs, FL 33076-3388
Phone
(954) 752-6974
NPI assigned
Jun 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X
Physical Therapy Assistant 225200000X PTA0013427 CO
Physical Therapy Assistant 225200000X A-1341 NM Primary

Addresses

Primary practice location

5830 Coral Ridge Dr Ste 300
Coral Springs, FL 33076-3388

Mailing address

8789 W Eastman Dr
Lakewood, CO 80227-4721
Phone (913) 909-5586

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
PTA0013427COMDPhysical Therapy Assistant
A-1341NMMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1902160427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8789 W EASTMAN DR",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802274721",
            "telephone_number": "913-909-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 CORAL RIDGE DR STE 300",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763388",
            "telephone_number": "954-752-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHSIKOMER",
        "first_name": "JESSICA",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "PTA0013427",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "A-1341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.