Active NPI
For Life Therapy Inc
- Physical Therapy Clinic/Center
- Watertown, SD
National Provider Identifier
1396009197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- License
- 1508
- Legal business name
- FOR LIFE THERAPY INC
- Practice address
- 913 10TH Ave SE
Watertown, SD 57201 - Phone
- (605) 878-3334
- NPI assigned
- Jun 27, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jacob Tesch, PT,DPT
- Title
- President
- Phone
- (605) 878-3334
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 1508 | SD | Primary |
Addresses
Primary practice location
913 10TH Ave SE
Watertown, SD 57201
Mailing address
913 10TH Ave SE
Watertown, SD 57201
Phone (605) 878-3334
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120709000154 | SD | Part B Supplier - Clinic/Group Practice | 4385809870 |
Receives reassigned benefits from 5 practitioners Practice locations: Watertown, SD |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Omaha, NE
- NPI 1073863007
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340755200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1340755200000",
"number": "1396009197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "913 10TH AVE SE",
"city": "WATERTOWN",
"state": "SD",
"postal_code": "57201",
"telephone_number": "605-878-3334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "913 10TH AVE SE",
"city": "WATERTOWN",
"state": "SD",
"postal_code": "57201",
"telephone_number": "605-878-3334"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOR LIFE THERAPY INC",
"organizational_subpart": "NO",
"enumeration_date": "2012-06-27",
"last_updated": "2012-06-27",
"status": "A",
"authorized_official_last_name": "TESCH",
"authorized_official_first_name": "JACOB",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "605-878-3334",
"authorized_official_credential": "PT,DPT"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": "SD",
"license": "1508",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.