Jaqulyn Dianne Thomas, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.009338 Issued in IL

Practice address

600 S Maple St
Piper City, IL 60959-7095

Phone

(815) 686-2277

Fax

(815) 686-2560

NPI assigned

Aug 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jaqulyn D Hughes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1982371902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S MAPLE ST",
            "city": "PIPER CITY",
            "state": "IL",
            "postal_code": "609597095",
            "telephone_number": "815-686-2277",
            "fax_number": "815-686-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S MAPLE ST",
            "city": "PIPER CITY",
            "state": "IL",
            "postal_code": "609597095",
            "telephone_number": "815-686-2277",
            "fax_number": "815-686-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JAQULYN",
        "middle_name": "DIANNE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.009338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAQULYN",
            "last_name": "HUGHES",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Greenbrier Lodge, Inc.
• Greenbrier Senior Living Community, LLC
• Piper Hco, LLC
• Piper Hco, LLC
• Miranda Leanne Rettell, PTA

• Physical Therapy Assistant in Piper City, IL
• Providers in Piper City, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.