Jonathan Dale James
Individual provider Active NPI Physical Therapy Assistant · Humboldt, TN
NPI 1972067619 · NPPES record last updated Jan 28, 2019
Key facts
- NPI
- 1972067619
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 5455 (TN)
- Practice address
- 2865 E Main St
Humboldt, TN 38343-3070 - Phone
- (731) 824-5817
- NPI assigned
- Jan 28, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5455 | TN | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5455 | TN | Yes |
Addresses
Primary practice location
2865 E Main St
Humboldt, TN 38343-3070
Mailing address
2865 E Main St
Humboldt, TN 38343-3070
Phone (731) 824-5817
Other providers in Humboldt, TN
- Humboldt General Hospital
- Humboldt Healthcare and Rehab Center, LLC
- Humboldt Nursing Home, Inc.
- Bobbi Jean Jackson
- Jennifer Jo Jackson
- Katherine Elizabeth James
- Kelly Napier Johnston
- William B Jones
- Yeo Seol Kang
- Nada Kattoum
All providers in Humboldt, TN · Physical Therapy Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.