Active NPI
Jessica McKenney
- Physical Therapy Assistant
- De Smet, SD
National Provider Identifier
1013472992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 0480
- Practice address
- 411 Calumet Ave NW
De Smet, SD 57231-2114 - Phone
- (605) 854-3327
- NPI assigned
- Feb 5, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 0480 | SD | Primary |
Addresses
Primary practice location
411 Calumet Ave NW
De Smet, SD 57231-2114
Mailing address
2421 Yorkshire Dr
Brookings, SD 57006-2436
Other practice location 1
2421 Yorkshire Dr
Brookings, SD 57006-2436
Phone (605) 696-8773
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0480 | SD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549324800000",
"number": "1013472992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2421 YORKSHIRE DR",
"city": "BROOKINGS",
"state": "SD",
"postal_code": "570062436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 CALUMET AVE NW",
"city": "DE SMET",
"state": "SD",
"postal_code": "572312114",
"telephone_number": "605-854-3327"
}
],
"practiceLocations": [
{
"address_1": "2421 Yorkshire Dr",
"address_purpose": "LOCATION",
"city": "Brookings",
"state": "SD",
"postal_code": "570062436",
"country_code": "US",
"telephone_number": "605-696-8773",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCKENNEY",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-05",
"last_updated": "2019-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "SD",
"license": "0480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in De Smet, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.