Jason Klobucher, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11805-024 Issued in WI

Practice address

220 3Rd Ave W Ste B
Ashland, WI 54806-1616

Phone

(715) 685-9656

Fax

(715) 685-9544

NPI assigned

Jul 11, 2011

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 WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Lakes Community Health Center IncGroup PAC ID 0840366654, 104 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Lakes Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Iron River, WI
  • NPI 1811178825
  Medicare reassignment Care Compare group NPD
• The Lakes Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • White Lake, WI
  • NPI 1679983423
  NPD
• The Lakes Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Lakewood, WI
  • NPI 1699778233
  NPD (past)
• The Lakes Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Solon Springs, WI
  • NPI 1942072988
  NPD (past)

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1093003188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 N PROVIDENCE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138018",
            "telephone_number": "920-257-2000",
            "fax_number": "920-257-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 3RD AVE W STE B",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548061616",
            "telephone_number": "715-685-9656",
            "fax_number": "715-685-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOBUCHER",
        "first_name": "JASON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-11",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11805-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace M Kilbane, PHARM D
• Lisa Ogimaakwe Kingfisher, PHARMD, RPH
• Carole Kjellander, PH.D.
• Robyn Marie Klaboe, COTA
• Johnna L Klein
• Tonya Sue Koenig-Colsch, LPC
• Mitchell John Kontny, DPT
• Jerelyn Mary Koosmann, RDH
• Aurelia Barbara Koziel-Andrzejewska
• Leisha Kramolis

• Physical Therapist in Ashland, WI
• Providers in Ashland, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.