Jacob Lee Mundy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05014242A Issued in IN

Practice address

1900 Saint Charles St
Jasper, IN 47546-9145

Phone

(812) 639-9216

NPI assigned

Aug 9, 2021

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 IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deaconess Specialty Physicians, IncGroup PAC ID 0244595205, 228 clinicians

Norris and Love Orthopaedic and Sports PCGroup PAC ID 4981695228, 12 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

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.

• Deaconess Specialty Physicians, Inc

  • Cardiovascular Disease Physician
  • Evansville, IN
  • NPI 1306344817
  Medicare reassignment Care Compare group NPD
• Norris & Love Orthopaedic & Sports PC

  • Orthopaedic Surgery Physician
  • Jasper, IN
  • NPI 1376507798

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Deaconess Specialty Physicians Inc

  • Psychiatry Physician
  • Evansville, IN
  • NPI 1811737299
  NPD
• Deaconess Specialty Physicians Inc

  • Family Medicine Physician
  • Huntingburg, IN
  • NPI 1831980945
  NPD
• Novenza Practice Group II

  • Geriatric Medicine (Internal Medicine) Physician
  • Greenwood, IN
  • NPI 1417806068
  NPD (past)

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1154095578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 TIMBER LINE DR",
            "city": "HUNTINGBURG",
            "state": "IN",
            "postal_code": "475428001",
            "telephone_number": "812-639-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SAINT CHARLES ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469145",
            "telephone_number": "812-639-9216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDY",
        "first_name": "JACOB",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05014242A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Moore-Nolan, LCSW
• Nicole Ann Moore, PTA
• Richard Moss, M.D.
• Mundy Chiropractic, LLC
• Alexander Mundy
• Lydia M Mundy, DC
• Joseph H Munning, M.D.
• Kathleen Ann Munning, APN
• Layla Murawski
• Tiffany J Murrell, FNP-C

• Physical Therapist in Jasper, IN
• Providers in Jasper, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.