Individual provider Active NPI

Jacqueline Van Duijn, DPT

  • Physical Therapist
  • Fort Myers, FL
National Provider Identifier
1316535602
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6344 Issued in FL
Practice address
12601 Strathmore Loop
Fort Myers, FL 33912-4693
Phone
(239) 464-1151
NPI assigned
Jan 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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 6344 FL Primary

Addresses

Primary practice location

12601 Strathmore Loop
Fort Myers, FL 33912-4693

Mailing address

12601 Strathmore Loop
Fort Myers, FL 33912-4693
Phone (239) 464-1151

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6344FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1316535602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12601 STRATHMORE LOOP",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124693",
            "telephone_number": "239-464-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12601 STRATHMORE LOOP",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124693",
            "telephone_number": "239-464-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DUIJN",
        "first_name": "JACQUELINE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "6344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.