Individual provider Active NPI

Jessica Lemus, DPT

  • Physical Therapist
  • Lawrence, KS
National Provider Identifier
1164090429
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-06757 Issued in KS
Practice address
535 Gateway Dr
Lawrence, KS 66049-2342
Phone
(785) 331-0106
Fax
(785) 331-0107
NPI assigned
Jun 14, 2021
Last updated
Jun 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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 11-06757 KS Primary

Addresses

Primary practice location

535 Gateway Dr
Lawrence, KS 66049-2342

Mailing address

535 Gateway Dr
Lawrence, KS 66049-2342
Phone (785) 331-0106

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210712003909 KS Practitioner - Physical Therapist in Private Practice 0042612129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bird Physical Therapy PAGroup PAC ID 1951353648, 3 clinicians

Practice addresses (Care Compare)

535 Gateway Dr
Lawrence, KS 66049-2342
Phone (785) 331-0106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-06757KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bird Physical Therapy PA Physical Therapist CurrentSince Jun 11, 2021 Accepting new patients

Locations

535 Gateway Dr
Lawrence, KS 66049
Phone (785) 331-0106

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1164090429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 GATEWAY DR",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660492342",
            "telephone_number": "785-331-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 GATEWAY DR",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660492342",
            "telephone_number": "785-331-0106",
            "fax_number": "785-331-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMUS",
        "first_name": "JESSICA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-06757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.