Jodi M Zupancich

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1273-019 Issued in WI

Practice address

7815 3Rd St N Ste 203
Oakdale, MN 55128-5443

Phone

(952) 835-4512

Fax

(952) 300-2004

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Viverant PT LLC

  • Physical Therapist
  • Oakdale, MN
  • NPI 1346553179
  NPD (past)
• Viverant, LLC

  • Physical Therapist
  • Oakdale, MN
  • NPI 1760418164
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1356362644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7815 3RD ST N STE 203",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285443",
            "telephone_number": "952-835-4512",
            "fax_number": "952-300-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7815 3RD ST N STE 203",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285443",
            "telephone_number": "952-835-4512",
            "fax_number": "952-300-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUPANCICH",
        "first_name": "JODI",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1273-019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA",
            "identifier": "1273-019",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN STATE",
            "identifier": "A1765",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Irina Zaltsgendler, D.D.S.
• Bruktawit Zewdie
• Tyler Zgodava, BA
• Brian J Zirbes, LADC
• Milos Zivkovic, MD

• Physical Therapy Assistant in Oakdale, MN
• Providers in Oakdale, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.