Individual provider Active NPI

Jessica Lynn Meeusen, DPT

  • Physical Therapist
  • Grafton, WI
National Provider Identifier
1053880419
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14384-24 Issued in WI
Practice address
2020 Cheyenne CT
Grafton, WI 53024-9368
Phone
(262) 375-1075
Fax
(262) 375-4975
NPI assigned
Nov 15, 2018
Last updated
Jun 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 14384-24 WI Primary

Addresses

Primary practice location

2020 Cheyenne CT
Grafton, WI 53024-9368

Mailing address

2020 Cheyenne CT
Grafton, WI 53024-9368
Phone (262) 375-1075

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181211001115 WI Practitioner - Physical Therapist in Private Practice 9335483817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Body Renovation Physical Therapy SCGroup PAC ID 3779688403, 15 clinicians

Practice addresses (Care Compare)

2020 Cheyenne CT
Grafton, WI 53024-9368
Phone (262) 375-1075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Body Renovation Physical Therapy SC Physical Therapist CurrentSince Jun 1, 2025 Accepting new patients
Body Renovation Health Services, S.C. PastSince Jun 1, 2025 Accepting new patients
Elite Sport & Spine, LLC Physical Therapist PastSince Nov 2, 2013 Accepting new patients
Vita Physical Therapy SC Physical Therapist PastSince Apr 1, 2019 Accepting new patients

Locations

2020 Cheyenne Ct
Grafton, WI 53024
Phone (262) 375-1075

10590 N Port Washington Rd
Mequon, WI 53092
Phone (262) 375-1075

20900 Swenson Dr
Ste 575
Waukesha, WI 53186
Phone (262) 373-9168

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1053880419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 CHEYENNE CT",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249368",
            "telephone_number": "262-375-1075",
            "fax_number": "262-375-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CHEYENNE CT",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249368",
            "telephone_number": "262-375-1075",
            "fax_number": "262-375-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEUSEN",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14384-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grafton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.