Individual provider Active NPI

Jennifer Lee Young, PT

  • Physical Therapist
  • Glenwood, IA
National Provider Identifier
1053508697
Registry record updated Mar 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
105915 Issued in IA
Practice address
55690 237TH St
Glenwood, IA 51534-5362
Phone
(712) 310-9118
NPI assigned
Sep 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7848 AZ
Physical Therapist 225100000X 105915 IA Primary
Physical Therapist 225100000X 2910 NE

Addresses

Primary practice location

55690 237TH St
Glenwood, IA 51534-5362

Mailing address

55690 237TH St
Glenwood, IA 51534-5362
Phone (712) 310-9118

Other names 1

  • Jennifer Lee Tjeerdsma Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210615002130 IA Practitioner - Physical Therapist in Private Practice 8123428026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Glenwood, IA 51534
Phone (712) 310-9118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7848AZMDPhysical Therapist
105915IAMDPhysical Therapist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740873600000",
    "number": "1053508697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55690 237TH ST",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515345362",
            "telephone_number": "712-310-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55690 237TH ST",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515345362",
            "telephone_number": "712-310-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-27",
        "last_updated": "2025-03-02",
        "certification_date": "2025-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "7848",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "105915",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "2910",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "TJEERDSMA",
            "middle_name": "LEE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glenwood, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.