Individual provider Active NPI

Jacob Weber Joyner, PT, DPT

  • Physical Therapist
  • Peoria, AZ
National Provider Identifier
1952066359
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
31979 Issued in AZ
Practice address
24737 N Lake Pleasant Pkwy Ste 106
Peoria, AZ 85383-1569
Phone
(623) 289-3200
Fax
(623) 223-5072
NPI assigned
Nov 1, 2021
Last updated
Aug 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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 31979 AZ Primary

Addresses

Primary practice location

24737 N Lake Pleasant Pkwy Ste 106
Peoria, AZ 85383-1569

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (678) 575-1980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912003427 AZ Practitioner - Physical Therapist in Private Practice 1052851300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

24737 N Lake Pleasant Pkwy
Suite 106
Peoria, AZ 85383-1569
Phone (623) 289-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31979AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Aug 30, 2024 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Aug 30, 2024 Accepting new patients

Locations

6070 W Bell Rd
Ste A103
Glendale, AZ 85308
Phone (602) 782-3965

24737 N Lake Pleasant Pkwy
Ste 106
Peoria, AZ 85383
Phone (623) 289-3200

21043 N Cave Creek Rd
Ste A1
Phoenix, AZ 85024
Phone (602) 483-5600

8270 S Houghton Rd
Ste 180
Tucson, AZ 85747
Phone (520) 664-1430

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

Interoperability endpoints

  • Direct secure messaging: jacob.joyner.p6@direct.athleticoltd.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1952066359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "678-575-1980",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24737 N LAKE PLEASANT PKWY STE 106",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853831569",
            "telephone_number": "623-289-3200",
            "fax_number": "623-223-5072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOYNER",
        "first_name": "JACOB",
        "middle_name": "WEBER",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-01",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "31979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.