Active NPI
Julie Marie Halvorsen-Jacobs, P.T.
- Specialist
- Oshkosh, WI
National Provider Identifier
1235249202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 3278-024
- Practice address
- 2300 State Road 44
Oshkosh, WI 54904-9137 - Phone
- (920) 233-2372
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 3278-024 | WI | Primary |
Addresses
Primary practice location
2300 State Road 44
Oshkosh, WI 54904-9137
Mailing address
W4264 Kiekhaefer Pkwy
Fond Du Lac, WI 54935-6801
Phone (920) 922-4116
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 |
|---|---|---|---|
| 3278-024 | WI | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235249202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W4264 KIEKHAEFER PKWY",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549356801",
"telephone_number": "920-922-4116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 STATE ROAD 44",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "549049137",
"telephone_number": "920-233-2372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALVORSEN-JACOBS",
"first_name": "JULIE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WI",
"license": "3278-024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oshkosh, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.