Active NPI
Jacob Thompson, PT
- Physical Therapist
- Hudson, WI
National Provider Identifier
1295281491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13421-24
- Practice address
- 742 Sterbenz Dr
Hudson, WI 54016-8327 - Phone
- (715) 386-2128
- Fax
- (715) 386-6119
- NPI assigned
- Aug 28, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | 13421-24 | WI | Primary |
Addresses
Primary practice location
742 Sterbenz Dr
Hudson, WI 54016-8327
Mailing address
St Croix Therapy, Inc.
742 Sterbenz Drive
Hudson, WI 54016
Phone (715) 386-2128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13421-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472342400000",
"number": "1295281491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ST CROIX THERAPY, INC.",
"address_2": "742 STERBENZ DRIVE",
"city": "HUDSON",
"state": "WI",
"postal_code": "54016",
"telephone_number": "715-386-2128",
"fax_number": "715-386-6119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "742 STERBENZ DR",
"city": "HUDSON",
"state": "WI",
"postal_code": "540168327",
"telephone_number": "715-386-2128",
"fax_number": "715-386-6119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "JACOB",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-28",
"last_updated": "2016-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "13421-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hudson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.