Kara Jean Jacobsen, P.T. MLD/CDT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10720 Issued in MA

Practice address

36 Chickering Dr Unit 106
Brattleboro, VT 05301-4419

Phone

(802) 258-2337

Fax

(802) 258-2307

NPI assigned

Aug 29, 2006

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

• Kara Jean Cenzano Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 31, 2020.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1285743849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 CHICKERING DR UNIT 106",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053014419",
            "telephone_number": "802-258-2337",
            "fax_number": "802-258-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 CHICKERING DR UNIT 106",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053014419",
            "telephone_number": "802-258-2337",
            "fax_number": "802-258-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "KARA",
        "middle_name": "JEAN",
        "credential": "P.T. MLD/CDT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "10720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y68357",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "1294632",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0399132",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "468310",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARA",
            "last_name": "CENZANO",
            "middle_name": "JEAN",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Brattleboro, VT
• Physical Therapist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.