Active NPI
Jennifer D'Urso, PT
- Physical Therapist
- Mequon, WI
National Provider Identifier
1033665120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6090-024
- Practice address
- 1249 W Liebau Rd
Mequon, WI 53092-3396 - Phone
- (262) 243-4161
- Fax
- (262) 243-4166
- NPI assigned
- Aug 29, 2016
- 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 Therapist | 225100000X | 6090-024 | WI | Primary |
Addresses
Primary practice location
1249 W Liebau Rd
Mequon, WI 53092-3396
Mailing address
1249 W Liebau Rd
Mequon, WI 53092-3396
Phone (262) 243-4161
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 |
|---|---|---|---|
| 6090-024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1033665120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1249 W LIEBAU RD",
"city": "MEQUON",
"state": "WI",
"postal_code": "530923396",
"telephone_number": "262-243-4161",
"fax_number": "262-243-4166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1249 W LIEBAU RD",
"city": "MEQUON",
"state": "WI",
"postal_code": "530923396",
"telephone_number": "262-243-4161",
"fax_number": "262-243-4166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'URSO",
"first_name": "JENNIFER",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-29",
"last_updated": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "6090-024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.