NPIMap

Organization Active NPI

Jacob's Ladder Pediatric Rehab Center

  • Physical Therapist
  • Chesterton, IN
National Provider Identifier
1265519151
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
JACOB'S LADDER PEDIATRIC REHAB CENTER
Practice address
1595 S Calumet Rd Ste 3
Chesterton, IN 46304-2389
Phone
(219) 763-6858
Fax
(219) 763-4858
NPI assigned
Oct 31, 2006
Last updated
Mar 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Authorized official

Name
Mrs. Tracy Hall
Title
Director of Admin Operations
Phone
(219) 250-3203

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

1595 S Calumet Rd Ste 3
Chesterton, IN 46304-2389

Mailing address

1595 S Calumet Rd Ste 3
Chesterton, IN 46304-2389
Phone (219) 764-4888

Other practice location 1

651 W Morgan Ave Ste 3
Chesterton, IN 46304
Phone (219) 250-3216

Other identifiers 1

IdentifierTypeStateIssuer
200196020AMedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
Jacob's Ladder First Steps Program2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1595 S Calumet Rd
Ste 3
Chesterton, IN 46304
Phone (219) 250-3202

651 W Morgan Ave
Ste 3
Chesterton, IN 46304
Phone (219) 250-3216

Practitioners & affiliated clinicians

Practitioners 89

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 89

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1265519151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 S CALUMET RD STE 3",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042389",
            "telephone_number": "219-764-4888",
            "fax_number": "219-764-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 S CALUMET RD STE 3",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042389",
            "telephone_number": "219-763-6858",
            "fax_number": "219-763-4858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "651 W Morgan Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Chesterton",
            "state": "IN",
            "postal_code": "46304",
            "country_code": "US",
            "telephone_number": "219-250-3216",
            "fax_number": "219-898-4258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACOB'S LADDER PEDIATRIC REHAB CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "DIRECTOR OF ADMIN OPERATIONS",
        "authorized_official_telephone_number": "219-250-3203",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200196020A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.