Individual provider Active NPI

Jasmine Dantzler

  • Physical Therapist
  • Evansville, IN
National Provider Identifier
1205666161
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05015650A Issued in IN
Practice address
415 Crosslake Dr Ste B
Evansville, IN 47715-8272
Phone
(812) 476-0409
Fax
(812) 476-1016
NPI assigned
Aug 6, 2024
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 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 05015650A IN Primary

Addresses

Primary practice location

415 Crosslake Dr Ste B
Evansville, IN 47715-8272

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (726) 202-3039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MD, DC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20240826002042 IN Practitioner - Physical Therapist in Private Practice 1951840610 Reassigns benefits to 3 organizations
I20251114002976 MD Practitioner - Physical Therapist in Private Practice 1951840610 Reassigns benefits to 1 organization
I20260330002078 DC Practitioner - Physical Therapist in Private Practice 1951840610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Prorehab IncGroup PAC ID 1254317217, 81 clinicians
Rehab 2 Perform LLCGroup PAC ID 6002199064, 92 clinicians

Practice addresses (Care Compare)

415 Crosslake Dr
Suite B
Evansville, IN 47715-8263
Phone (812) 476-0409

9315 Largo Dr W
Suite 100
Upper Marlboro, MD 20774-4749
Phone (301) 798-4838

983 Waugh Chapel Way
Suite Ab
Gambrills, MD 21054-1261
Phone (301) 798-4838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30631MDMDClinical Social Worker
05015650AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Orthopaedic Surgeons, Inc. Current Accepting new patients
Orthopaedics-Indianapolis, Inc CurrentSince Jul 1, 2025 Accepting new patients
Rehab 2 Perform LLC Physical Therapist CurrentSince Nov 3, 2025 Accepting new patients
Rehab 2 Perform LLC Physical Therapist Current Accepting new patients
Orthopaedics-Indianapolis, Inc CurrentSince Jul 1, 2025 Accepting new patients
Orthopaedics-Indianapolis, Inc Physical Therapist Current Accepting new patients
Rehab 2 Perform LLC Physical Therapist CurrentSince Nov 3, 2025 Accepting new patients
Tri-State Orthopaedic Surgeons, Inc. CurrentSince May 10, 2025 Accepting new patients
Tri-State Orthopaedic Surgeons, Inc. Physical Therapist CurrentSince May 10, 2025 Accepting new patients
Prorehab Inc Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients
Prorehab Inc Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients

Locations

3070 Warrick Dr
Boonville, IN 47601
Phone (812) 431-0517

225 Crosslake Dr
Evansville, IN 47715
Phone (812) 471-6677

415 Crosslake Dr
Ste B
Evansville, IN 47715
Phone (812) 476-0764

4659 N 1st Ave
Evansville, IN 47710
Phone (812) 759-3001

5625 Pearl Dr
Ste 100
Evansville, IN 47712
Phone (812) 759-7493

5625 Pearl Dr
Ste 101
Evansville, IN 47712
Phone (812) 474-3800

75 Industrial Park Rd
Ste D
Ferdinand, IN 47532
Phone (502) 882-9379

10294 S 150 E
Haubstadt, IN 47639
Phone (812) 768-5207

8450 Northwest Blvd
Indianapolis, IN 46278

8887 High Pointe Dr
Ste E
Newburgh, IN 47630
Phone (812) 759-7464

1952 S State Road 57
Oakland City, IN 47660
Phone (812) 999-3070

826 N State Road 161
Ste B
Rockport, IN 47635
Phone (812) 627-7007

2121 Willow St
Vincennes, IN 47591
Phone (812) 882-1141

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

1750 Forest Dr
Ste 145
Annapolis, MD 21401
Phone (301) 381-0738

1341 Hughes Ford Rd
Ste 104
Frederick, MD 21701
Phone (301) 450-8038

983 Waugh Chapel Way
Ste A
Gambrills, MD 21054

983 Waugh Chapel Way
Ste Ab
Gambrills, MD 21054
Phone (301) 603-3008

20501 Seneca Meadows Pkwy
Ste 100
Germantown, MD 20876
Phone (240) 608-0986

9315 Largo Dr W
Ste 100
Upper Marlboro, MD 20774

Organizations & group practices 11

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": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1205666161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "726-202-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 CROSSLAKE DR STE B",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158272",
            "telephone_number": "812-476-0409",
            "fax_number": "812-476-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTZLER",
        "first_name": "JASMINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05015650A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.