Active NPI
Jordan A Everett
- Physical Therapist
- Indianapolis, IN
National Provider Identifier
1245590298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05010910A
- Practice address
- 6920 Gatwick Dr Ste 120
Indianapolis, IN 46241-9506 - Phone
- (317) 856-1162
- Fax
- (317) 821-0455
- NPI assigned
- May 24, 2012
- Last updated
- Jan 8, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05010910A | IN | Primary |
Addresses
Primary practice location
6920 Gatwick Dr Ste 120
Indianapolis, IN 46241-9506
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201084780 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
369 Grand Valley Blvd
Martinsville, IN 46151-5851
Phone (765) 349-9255
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.3 of 100
- Quality
- 88.48
- Improvement activities
- 40
- Cost
- 72.11
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
dba ATI Physical Therapy
- Physical Therapist
- Indianapolis, IN
- NPI 1316940505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420675200000",
"number": "1245590298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223",
"fax_number": "630-759-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6920 GATWICK DR STE 120",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462419506",
"telephone_number": "317-856-1162",
"fax_number": "317-821-0455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERETT",
"first_name": "JORDAN",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-24",
"last_updated": "2015-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05010910A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201084780",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.