Active NPI
Nicole Jakubowicz, PT, DPT
- Physical Therapist
- Bloomington, IN
National Provider Identifier
1376002220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 155 E Burks Dr
Bloomington, IN 47401-8459 - Phone
- (812) 332-4437
- NPI assigned
- Mar 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
155 E Burks Dr
Bloomington, IN 47401-8459
Mailing address
155 E Burks Dr
Bloomington, IN 47401-8459
Phone (812) 332-4437
Other practice location 1
800 E Ohio St
Jasonville, IN 47438-1607
Phone (812) 665-2226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1376002220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 E BURKS DR",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474018459",
"telephone_number": "812-332-4437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 E BURKS DR",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474018459",
"telephone_number": "812-332-4437"
}
],
"practiceLocations": [
{
"address_1": "800 E Ohio St",
"address_purpose": "LOCATION",
"city": "Jasonville",
"state": "IN",
"postal_code": "474381607",
"country_code": "US",
"telephone_number": "812-665-2226",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JAKUBOWICZ",
"first_name": "NICOLE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-19",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.