Individual provider Active NPI

Courtney Jacobsen, PT

  • Physical Therapist
  • Oskaloosa, IA
National Provider Identifier
1104668581
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
124779 Issued in IA
Practice address
1412 A Ave W Ste a
Oskaloosa, IA 52577-1970
Phone
(641) 676-3535
NPI assigned
Jun 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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 124779 IA Primary

Addresses

Primary practice location

1412 A Ave W Ste a
Oskaloosa, IA 52577-1970

Mailing address

1000 E 17TH St S
Newton, IA 50208-5000
Phone (641) 521-4839

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240619000482 IA Practitioner - Physical Therapist in Private Practice 7315480332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Work Systems Rehab PCGroup PAC ID 5193619625, 35 clinicians

Practice addresses (Care Compare)

1412 A Ave W a
Kinetic Edge Physical Therapy
Oskaloosa, IA 52577-1970
Phone (641) 676-3535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124779IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Work Systems Rehab, PC Physical Therapist CurrentSince Jun 7, 2024 Accepting new patients

Locations

516 3rd St
Des Moines, IA 50309
Phone (515) 309-4706

1715 1st Ave E
Newton, IA 50208
Phone (641) 791-9675

1412 A Ave W
Ste A
Oskaloosa, IA 52577
Phone (641) 676-3535

604 Liberty St
Ste 227
Pella, IA 50219
Phone (641) 204-0046

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": "1717718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1104668581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 17TH ST S",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502085000",
            "telephone_number": "641-521-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 A AVE W STE A",
            "city": "OSKALOOSA",
            "state": "IA",
            "postal_code": "525771970",
            "telephone_number": "641-676-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "COURTNEY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-07",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "124779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oskaloosa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.