Active NPI
Kelsey Marie Jacobs, DPT
- Physical Therapist
- Minneapolis, MN
National Provider Identifier
1174077929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10418
- Practice address
- 6401 France Ave S
Minneapolis, MN 55435-2104 - Phone
- (952) 924-1340
- NPI assigned
- Aug 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 10418 | MN | Primary |
Addresses
Primary practice location
6401 France Ave S
Minneapolis, MN 55435-2104
Mailing address
6401 France Ave S
Minneapolis, MN 55435-2104
Phone (952) 924-1340
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10418 | MN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470787200000",
"number": "1174077929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6401 FRANCE AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554352104",
"telephone_number": "952-924-1340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6401 FRANCE AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554352104",
"telephone_number": "952-924-1340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "KELSEY",
"middle_name": "MARIE",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-10",
"last_updated": "2016-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "10418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.