Individual provider Active NPI

Jennifer Joy Louraine

  • Physical Therapy Assistant
  • Fort Wayne, IN
National Provider Identifier
1205091675
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06002434A Issued in IN
Practice address
7426 Tipperary TRL
Fort Wayne, IN 46815-8122
Phone
(260) 749-2148
NPI assigned
Jul 24, 2008
Last updated
Jul 24, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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 06002434A IN Primary

Addresses

Primary practice location

7426 Tipperary TRL
Fort Wayne, IN 46815-8122

Mailing address

7426 Tipperary TRL
Fort Wayne, IN 46815-8122
Phone (260) 749-2148

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
06002434AINMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1205091675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7426 TIPPERARY TRL",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468158122",
            "telephone_number": "260-749-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7426 TIPPERARY TRL",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468158122",
            "telephone_number": "260-749-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOURAINE",
        "first_name": "JENNIFER",
        "middle_name": "JOY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-24",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06002434A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.