Active NPI
Jamie Marie Deerr, DPT
- Physical Therapist
- Greenwood, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05013352A
- Practice address
- 3000 S State Road 135
Greenwood, IN 46143-9825 - Phone
- (317) 535-4075
- NPI assigned
- Jun 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05013352A | IN | Primary |
Addresses
Primary practice location
3000 S State Road 135
Greenwood, IN 46143-9825
Mailing address
4032 Woodstone Dr
Floyds Knobs, IN 47119-9718
Phone (502) 762-3849
Other names 1
- Jamie Marie Wallace
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3000 S State Rd
135 Suite 110
Greenwood, IN 46143-9829
Phone (317) 497-6000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05013352A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CHN JMH Ventures LLC | Current | Accepting new patients | |
| CHN JMH Ventures LLC | Physical Therapist | Current | Accepting new patients |
Locations
7598 Solutions Ctr
Chicago, IL 60677
3000 S State Road 135
Greenwood, IN 46143
Phone (317) 497-6000
3000 S State Road 135
Ste 110
Greenwood, IN 46143
Phone (317) 497-6000
Organizations & group practices 2
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.
-
- Physical Therapist
- Greenwood, IN
- NPI 1902242084
-
- Radiology Clinic/Center
- Greenwood, IN
- NPI 1134564016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646784000000",
"number": "1144889486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4032 WOODSTONE DR",
"city": "FLOYDS KNOBS",
"state": "IN",
"postal_code": "471199718",
"telephone_number": "502-762-3849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 S STATE ROAD 135",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461439825",
"telephone_number": "317-535-4075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEERR",
"first_name": "JAMIE",
"middle_name": "MARIE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-11",
"last_updated": "2022-03-09",
"certification_date": "2022-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05013352A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JAMIE",
"last_name": "WALLACE",
"middle_name": "MARIE",
"credential": "DPT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Greenwood, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.