Individual provider Active NPI

Robert Brandon Yocom, PTA

  • Physical Therapy Assistant
  • Grand Prairie, TX
National Provider Identifier
1912547514
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2130681 Issued in TX
Practice address
2100 Virginia St
Grand Prairie, TX 75051-3796
Phone
(972) 992-0190
NPI assigned
Jan 10, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2130681 TX Primary

Addresses

Primary practice location

2100 Virginia St
Grand Prairie, TX 75051-3796

Mailing address

10986 Duke Snider Cir
El Paso, TX 79934-3234
Phone (915) 479-7798

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
2130681TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1912547514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10986 DUKE SNIDER CIR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799343234",
            "telephone_number": "915-479-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 VIRGINIA ST",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750513796",
            "telephone_number": "972-992-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOCOM",
        "first_name": "ROBERT",
        "middle_name": "BRANDON",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2130681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.