Individual provider Active NPI

Jennifer Lynn Epperson, DPT

  • Physical Therapist
  • Moberly, MO
National Provider Identifier
1356513667
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2008008650 Issued in MO
Practice address
2100 Silva LN
Suite B
Moberly, MO 65270-3600
Phone
(660) 263-6223
Fax
(660) 263-6224
NPI assigned
Mar 26, 2008
Last updated
Nov 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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 2008008650 MO Primary

Addresses

Primary practice location

2100 Silva LN
Suite B
Moberly, MO 65270-3600

Mailing address

2100 Silva LN Ste B
Suite I
Moberly, MO 65270-3600
Phone (660) 263-6223

Other names 1

  • Jennifer Lynn Cushman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080725000710 MO Practitioner - Physical Therapist in Private Practice 8123191947 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Missouri Physical Therapy LLCGroup PAC ID 6901870187, 59 clinicians
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

2100 Silva LN
Suite B
Moberly, MO 65270-3600
Phone (660) 263-6223

2100 Silva LN
Suite B
Moberly, MO 65270-3678
Phone (660) 263-6223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2008008650MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Missouri Physical Therapy LLC Physical Therapist CurrentSince Jun 1, 2015 Accepting new patients
Boone Physician Services, LLC CurrentSince Aug 1, 2023 Accepting new patients
Westside Rehab, Inc Past Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

3301 Berrywood Dr
Ste 204
Columbia, MO 65201
Phone (573) 374-7579

126 S Main St
Gravois Mills, MO 65037
Phone (573) 374-7579

2100 Silva Ln
Ste B
Moberly, MO 65270
Phone (660) 263-6223

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1356513667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SILVA LN STE B",
            "address_2": "SUITE I",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652703600",
            "telephone_number": "660-263-6223",
            "fax_number": "660-263-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SILVA LN",
            "address_2": "SUITE B",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652703600",
            "telephone_number": "660-263-6223",
            "fax_number": "660-263-6224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPERSON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-26",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2008008650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "CUSHMAN",
            "middle_name": "LYNN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moberly, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.