Individual provider Active NPI

Jessica Marie Lawrence, DPT

  • Physical Therapist
  • Mankato, MN
National Provider Identifier
1366690232
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8196 Issued in MN
Practice address
1230 E Main St
Mankato, MN 56001-8001
Phone
(507) 389-8760
NPI assigned
Sep 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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 8196 MN Primary

Addresses

Primary practice location

1230 E Main St
Mankato, MN 56001-8001

Mailing address

1230 E Main St
Mankato, MN 56001-5066
Phone (507) 625-1811

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jessicalawrence@mklt.allscriptsdirect.net Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160108000224 MN Practitioner - Physical Therapist in Private Practice 0143522177 Reassigns benefits to 1 organization

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
Mankato Clinic LTDGroup PAC ID 5597677955, 243 clinicians

Practice addresses (Care Compare)

1230 Main St E
PO Box 8674
Mankato, MN 56002-8674
Phone (507) 625-1811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8196MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mankato Clinic LTD CurrentSince Mar 1, 2018 Accepting new patients

Locations

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

1230 E Main St
Mankato, MN 56001
Phone (507) 389-8502

Interoperability endpoints

  • Direct secure messaging: jessicalawrence@mklt.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1366690232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 E MAIN ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015066",
            "telephone_number": "507-625-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 E MAIN ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560018001",
            "telephone_number": "507-389-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessicalawrence@mklt.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Mankato Clinic Direct ID, Allscripts Community",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1230 E Main St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560018001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.