1689719312 NPI number — JAMI LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689719312 NPI number — JAMI LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMI LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SIGNIFICANT PHYSICAL THERAPY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689719312
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3017 MELBOURNE CT E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT JULIET
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37122-7540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-232-9201
Provider Business Mailing Address Fax Number:
615-232-9202

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4982 LEBANON PIKE
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
OLD HICKORY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37138-4107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-232-9201
Provider Business Practice Location Address Fax Number:
615-232-9202
Provider Enumeration Date:
02/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PACO
Authorized Official First Name:
MARTINA
Authorized Official Middle Name:
HERNANDEZ
Authorized Official Title or Position:
SECRETARY,TREASURER,PT
Authorized Official Telephone Number:
615-397-6627

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  SAVE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3728633 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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