Individual provider Active NPI

Jaymie L Fletcher, PT

  • Physical Therapist
  • Odessa, TX
National Provider Identifier
1912252552
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1218579 Issued in TX
Practice address
4407 N Grandview Ave
Odessa, TX 79762-5311
Phone
(432) 366-9541
Fax
(432) 366-1951
NPI assigned
Jul 19, 2012
Last updated
Aug 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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 1218579 TX Primary

Addresses

Primary practice location

4407 N Grandview Ave
Odessa, TX 79762-5311

Mailing address

4407 N Grandview Ave
Odessa, TX 79762-5311
Phone (432) 366-9541

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1912252552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4407 N GRANDVIEW AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625311",
            "telephone_number": "432-366-9541",
            "fax_number": "432-366-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 N GRANDVIEW AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625311",
            "telephone_number": "432-366-9541",
            "fax_number": "432-366-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "JAYMIE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1218579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.