Jared Story

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1679-019 Issued in WI

Practice address

9047 W Greenfield Ave
West Allis, WI 53214-2808

Phone

(414) 453-9290

Fax

(414) 607-0924

NPI assigned

Nov 2, 2010

Last updated

Dec 27, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1356641633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9047 W GREENFIELD AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532142808",
            "telephone_number": "414-453-9290",
            "fax_number": "414-607-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9047 W GREENFIELD AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532142808",
            "telephone_number": "414-453-9290",
            "fax_number": "414-607-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORY",
        "first_name": "JARED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-02",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1679-019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356641633",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nebojsa Stevanovic, MD
• Tatjana Stevanovic, NP
• Paul Ward Stevenson, M.D.
• Michael James Stoesz, MD
• David S Stolp, MD
• Maria Stout
• Roumiana B. Stoycheva, D.D.S.
• Collin Strasser
• Mary Anne Stream
• Erica N Strebig

• Physical Therapy Assistant in West Allis, WI
• Providers in West Allis, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; 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.