Active NPI
Jennifer Trebon, DPT
- Physical Therapist
- Independence, IA
National Provider Identifier
1043456858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 109008
- Practice address
- 2300 Swan Lake Blvd Ste 103
Independence, IA 50644-9708 - Phone
- (319) 334-5155
- Fax
- (319) 334-6166
- NPI assigned
- Dec 29, 2008
- Last updated
- Aug 23, 2024
- 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 | 109008 | IA | Primary |
Addresses
Primary practice location
2300 Swan Lake Blvd Ste 103
Independence, IA 50644-9708
Mailing address
2300 Swan Lake Blvd Ste 103
Independence, IA 50644-9708
Phone (319) 334-5155
Other practice location 1
11432 Business Blvd Ste 18
Eagle River, AK 99577-7740
Phone (907) 622-6363
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109008 | IA | MD | Physical Therapist |
| 2311 | AK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millennium Rehab & Consulting, Inc. | Physical Therapist | Past | Accepting new patients |
| Millennium Rehab & Consulting, Inc. | Physical Therapist | Past | Accepting new patients |
| Health Quest Therapy, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Millennium Therapy
- Physical Therapist
- Des Moines, IA
- NPI 1255385852
-
dba Millennium Therapy
- Physical Therapist
- Independence, IA
- NPI 1336193986
-
- Occupational Therapy Assistant
- Wasilla, AK
- NPI 1982727640
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724371200000",
"number": "1043456858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 SWAN LAKE BLVD STE 103",
"city": "INDEPENDENCE",
"state": "IA",
"postal_code": "506449708",
"telephone_number": "319-334-5155",
"fax_number": "319-334-6166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 SWAN LAKE BLVD STE 103",
"city": "INDEPENDENCE",
"state": "IA",
"postal_code": "506449708",
"telephone_number": "319-334-5155",
"fax_number": "319-334-6166"
}
],
"practiceLocations": [
{
"address_1": "11432 Business Blvd Ste 18",
"address_purpose": "LOCATION",
"city": "Eagle River",
"state": "AK",
"postal_code": "995777740",
"country_code": "US",
"telephone_number": "907-622-6363",
"fax_number": "907-622-6366",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TREBON",
"first_name": "JENNIFER",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-29",
"last_updated": "2024-08-23",
"certification_date": "2024-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "109008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Independence, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.