Jamie L Bockhop, PT/LAT
Individual provider Active NPI Physical Therapist · Baraboo, WI
NPI 1083836092 · NPPES record last updated May 6, 2013
Key facts
- NPI
- 1083836092
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 10782-24 (WI)
- Practice address
- 626 14TH Street
Suite 2
Baraboo, WI 53913 - Phone
- (608) 356-2334
- Fax
- (608) 356-2636
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10782-024 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wayne a Johansen | Past | Accepting new patients | |
| Janesville Physical Therapy and Rehab Specialists, LLC | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10782-024 | WI | |
| Physical Therapist | 225100000X | 10782-24 | WI | Yes |
Addresses
Primary practice location
626 14TH Street
Suite 2
Baraboo, WI 53913
Mailing address
PO Box 31
Baraboo, WI 53913
Phone (608) 356-2334
Other providers in Baraboo, WI
- Sarah Rose Beuthin
- Bio-Medical Applications of Wisconsin, Inc.
- Tiffany F Birrenkott
- Bradley J Bjorklund
- Kara A Bjorklund
- Alana Claire Bongard
- Renee Boone
- Robyn Renae Bradley
- Matthew Brelie
- Kaitlyn Brescia
All providers in Baraboo, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.