Individual provider Active NPI

Jennifer Lynn Kortz, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1245527225
Registry record updated Apr 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
291796 Issued in CA
Practice address
4831 Pico St
San Diego, CA 92109-3810
Phone
(412) 848-2714
NPI assigned
Jun 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT021316 PA
Physical Therapist 225100000X 291796 CA Primary

Addresses

Primary practice location

4831 Pico St
San Diego, CA 92109-3810

Mailing address

4831 Pico St
San Diego, CA 92109-3810
Phone (412) 848-2714

Other names 1

  • Jennifer Lynn Rockar 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)
Enrolled

State licenses

LicenseStateTypeSpecialty
035611NYMDOral and Maxillofacial Pathology Dentist
291796CAMDPhysical Therapist
PT021316PAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491004800000",
    "number": "1245527225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4831 PICO ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093810",
            "telephone_number": "412-848-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4831 PICO ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093810",
            "telephone_number": "412-848-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTZ",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2017-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT021316",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "291796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ROCKAR",
            "middle_name": "LYNN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2017; 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.