Jacqueline L Wells, DPT, CLT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

084790 Issued in IA

Practice address

509 N Madison St
Bloomfield, IA 52537-9988

Phone

(641) 664-7086

NPI assigned

Apr 14, 2025

Last updated

Apr 14, 2025By the provider in NPPES

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

• Mrs. Jacqueline Louise Kincart Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1396530952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N MADISON ST",
            "city": "BLOOMFIELD",
            "state": "IA",
            "postal_code": "525379988",
            "telephone_number": "641-664-7086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N MADISON ST",
            "city": "BLOOMFIELD",
            "state": "IA",
            "postal_code": "525379988",
            "telephone_number": "641-664-7086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "JACQUELINE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "DPT, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "084790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "KINCART",
            "middle_name": "LOUISE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas G Juhl, OD
• Meghan Todey, RT
• Susan Catherine Warner, DPM
• Wells Bros. Pharmacy Services, LLC (Wells Hometown Drug)
• Wells Bros. Pharmacy Services, LLC (Wells Hometown Drug)
• Mylo E Wells, PHARMD
• Douglas Alan Wetrich, RPH
• Megan Whisler, PNP
• Donald Richard Wirtanen, D.O.
• Janet E Zeitler, BS PHARMACY

• Physical Therapist in Bloomfield, IA
• Providers in Bloomfield, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.