Individual provider Active NPI

Jennifer Doyle, DPT

  • Physical Therapist
  • Erie, PA
National Provider Identifier
1255617486
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14651 Issued in CT
Practice address
4472 Buffalo Rd
Erie, PA 16510-2228
Phone
(814) 464-0660
Fax
(814) 464-0663
NPI assigned
Nov 2, 2011
Last updated
Sep 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT026046 PA
Physical Therapist 225100000X 19758 MA
Physical Therapist 225100000X 14651 CT Primary

Addresses

Primary practice location

4472 Buffalo Rd
Erie, PA 16510-2228

Mailing address

902 W Erie PLZ
Erie, PA 16505-4536
Phone (814) 456-6000

Other identifiers 1

IdentifierTypeStateIssuer
PT026046OtherPAPA LICENSE

Other names 1

  • Jennifer Mohns Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240926001003 CT Practitioner - Physical Therapist in Private Practice 6002073434 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19758MAMDPhysical Therapist
PT026046PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Connecticut, Inc. Physical Therapist CurrentSince Aug 24, 2024 Accepting new patients

Locations

101 N Plains Rd
Wallingford, CT 06492
Phone (203) 265-0018

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.

NPI Registry JSON

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1255617486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W ERIE PLZ",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165054536",
            "telephone_number": "814-456-6000",
            "fax_number": "814-456-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4472 BUFFALO RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165102228",
            "telephone_number": "814-464-0660",
            "fax_number": "814-464-0663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "JENNIFER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-02",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT026046",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "19758",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PT026046",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MOHNS",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.