Jacob Nienow, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10689 Issued in MN

Practice address

1230 E Main St
Mankato, MN 56001-5066

Phone

(507) 625-1811

NPI assigned

Mar 10, 2017

Last updated

Jun 21, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mankato Clinic LTDGroup PAC ID 5597677955, 243 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacobnienow@mklt.allscriptsdirect.net

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.

• Mankato Clinic LTD

  • Family Medicine Physician
  • Mankato, MN
  • NPI 1629044029
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498003200000",
    "number": "1073054995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 E MAIN ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015066",
            "telephone_number": "507-625-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 E MAIN ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015066",
            "telephone_number": "507-625-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIENOW",
        "first_name": "JACOB",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-10",
        "last_updated": "2017-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Mankato, MN
• Providers in Mankato, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; 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.