Individual provider Active NPI

Jarred Thomas Burns, DPT

  • Physical Therapist
  • Leo, IN
National Provider Identifier
1174080055
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05013272A Issued in IN
Practice address
13839 Amstutz Rd
Leo, IN 46765-9605
Phone
(260) 257-8956
Fax
(888) 607-1633
NPI assigned
Feb 27, 2019
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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 05013272A IN Primary

Addresses

Primary practice location

13839 Amstutz Rd
Leo, IN 46765-9605

Mailing address

PO Box 254
Leo, IN 46765-0254
Phone (260) 257-8956

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230922003623 IN Practitioner - Physical Therapist in Private Practice 9537526645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13839 Amstutz Rd
Leo, IN 46765-9605
Phone (260) 257-8956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Burns Physical Therapy and Wellness Company Physical Therapist CurrentSince Aug 6, 2023 Accepting new patients
Crossroads Wellness Center, LLC CurrentSince Apr 6, 2023 Accepting new patients

Locations

12812 Coldwater Rd
#101
Fort Wayne, IN 46845
Phone (260) 445-8389

13839 Amstutz Rd
Leo, IN 46765
Phone (260) 257-8956

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, 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": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1174080055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 254",
            "city": "LEO",
            "state": "IN",
            "postal_code": "467650254",
            "telephone_number": "260-257-8956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13839 AMSTUTZ RD",
            "city": "LEO",
            "state": "IN",
            "postal_code": "467659605",
            "telephone_number": "260-257-8956",
            "fax_number": "888-607-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "JARRED",
        "middle_name": "THOMAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-27",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013272A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.