Individual provider Active NPI

Jennifer Lynn Palovchik, PTA

  • Physical Therapy Assistant
  • Columbus, OH
National Provider Identifier
1184927261
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 03713 Issued in OH
Practice address
4821 Roberts Rd
Columbus, OH 43228-9496
Phone
(614) 850-1476
NPI assigned
Dec 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 03713 OH Primary

Addresses

Primary practice location

4821 Roberts Rd
Columbus, OH 43228-9496

Mailing address

7699 Perry Rd
Delaware, OH 43015-9117
Phone (740) 548-7270

Other names 1

  • Ms. Jennifer Lynn Upp Former name

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

LicenseStateTypeSpecialty
PTA 03713OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1184927261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7699 PERRY RD",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430159117",
            "telephone_number": "740-548-7270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4821 ROBERTS RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432289496",
            "telephone_number": "614-850-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOVCHIK",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA 03713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "UPP",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.