Individual provider Active NPI

Jensen Pearson, DPT

  • Physical Therapist
  • Oshkosh, WI
National Provider Identifier
1245924638
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16375-24 Issued in WI
Practice address
909 S Washburn St
Oshkosh, WI 54904-8051
Phone
(920) 235-8966
Fax
(920) 235-1526
NPI assigned
Jun 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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 16375-24 WI Primary

Addresses

Primary practice location

909 S Washburn St
Oshkosh, WI 54904-8051

Mailing address

909 S Washburn St
Oshkosh, WI 54904-8051
Phone (920) 235-8966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230705003336 WI Practitioner - Physical Therapist in Private Practice 7416316757 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Neurology Wisconsin SC CurrentSince Jun 20, 2024 Accepting new patients
Paxxon Healthcare Services LLC Physical Therapist CurrentSince Aug 14, 2024 Accepting new patients
Paxxon Healthcare Services LLC Physical Therapist CurrentSince Aug 14, 2024 Accepting new patients

Locations

1725 N Casaloma Dr
Appleton, WI 54913
Phone (888) 585-7975

478 W Arndt St
Fond du Lac, WI 54935
Phone (920) 933-6304

12200 N Corporate Pkwy
Ste 400
Mequon, WI 53092
Phone (888) 585-7975

1111 E Capitol Dr
Shorewood, WI 53211
Phone (262) 293-3207

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26712/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jensen.pearson.1@26712.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1245924638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 S WASHBURN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048051",
            "telephone_number": "920-235-8966",
            "fax_number": "920-235-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 S WASHBURN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048051",
            "telephone_number": "920-235-8966",
            "fax_number": "920-235-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "JENSEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16375-24",
            "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 Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.