Kelly Jenson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070-014044 Issued in IL

Practice address

16622 W 159TH St
Ste 503
Lockport, IL 60441-8014

Phone

(815) 838-5070

Fax

(815) 838-5071

NPI assigned

May 23, 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 names 1

• Kelly Van Wetering Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

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• Universal Health Institute, LTD

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  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1366497190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16622 W 159TH ST",
            "address_2": "STE 503",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604418014",
            "telephone_number": "815-838-5070",
            "fax_number": "815-838-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16622 W 159TH ST",
            "address_2": "STE 503",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604418014",
            "telephone_number": "815-838-5070",
            "fax_number": "815-838-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSON",
        "first_name": "KELLY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-014044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "VAN WETERING",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hiba Iqbal, DMD
• J4J Enterprises, LLC
• Fran Jackson
• Stacy Jager, MT-BC
• Kevin Jakowitsch, DC
• Chijioke Jimonu
• Justine Johnson, D.C.
• Lauren Johnson, OT
• Jennifer Jones, BCBA
• Nikkiba Tamele Jones, DNP

• Physical Therapist in Lockport, IL
• Providers in Lockport, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; 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.