Jacqueline Wiersma, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7437 Issued in AZ

Practice address

1930 E Southern Ave
Tempe, AZ 85282-7518

Phone

(480) 456-0719

NPI assigned

Sep 21, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empowerme Rehabilitation LLCGroup PAC ID 2769723162, 423 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Empowerme Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1144954074

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Empowerme Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Williamsburg, VA
  • NPI 1881366730

  Physical Therapist

  NPD
• Pioneer Pet, LLC

  • Diagnostic Radiology Physician
  • Tempe, AZ
  • NPI 1265401996
  NPD (past)
• Solace Pediatric Healthcare Therapy Services Az, Inc.

  • Physical Therapist
  • Tempe, AZ
  • NPI 1669533105
  NPD (past)
• Vibrantcare Outpatient Rehabilitation West Inc

  • Physical Therapy Clinic/Center
  • Phoenix, AZ
  • NPI 1114921871
  NPD (past)
• Vibrantcare Outpatient Rehabilitation West Inc

  • Physical Therapy Clinic/Center
  • Tucson, AZ
  • NPI 1699779223
  NPD (past)

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252972800000",
    "number": "1154517274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827518",
            "telephone_number": "480-456-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827518",
            "telephone_number": "480-456-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERSMA",
        "first_name": "JACQUELINE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2009-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "7437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260138",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Lynn Whitley-Janowski, SLP
• David Richardson Whitlock, DDS
• Elizabeth Whittier, MS, BCBA, LBA
• Keith Lofgreen Whyte, D.C.
• Beth Wieland, PT, DPT, CSCS
• James Brandon Wiese, PHARMD
• Kelly Wilcox, MS, OTR/L
• Wild & Well Recovery LLC
• Wild Willow Counseling, PLLC
• Charles Wilder

• Physical Therapist in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.