Active NPI
Jessica Lynn Haag, PT
- Physical Therapist
- York, PA
National Provider Identifier
1407038425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT019049
- Practice address
- 2821 E Prospect Rd
York, PA 17402-9213 - Phone
- (717) 840-1874
- Fax
- (717) 840-0968
- NPI assigned
- Nov 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | PT019049 | PA | Primary |
Addresses
Primary practice location
2821 E Prospect Rd
York, PA 17402-9213
Mailing address
2821 E Prospect Rd
York, PA 17402-9213
Phone (717) 840-1874
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18444 | Other | PA | HEALTH AMERICA |
| 0068377000 | Other | PA | AMERIHEALTH UNDER IBC |
| 177124 | Other | PA | HGSA PROVIDER NUMBER |
| 332313 | Other | PA | HIGHMARK BLUE SHIELD |
| 03182100 | Other | PA | CAPITAL BLUE CROSS |
| CK4276 | Other | PA | PALMETTO GBA RR MEDICARE |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366329600000",
"number": "1407038425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2821 E PROSPECT RD",
"city": "YORK",
"state": "PA",
"postal_code": "174029213",
"telephone_number": "717-840-1874",
"fax_number": "717-840-0968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2821 E PROSPECT RD",
"city": "YORK",
"state": "PA",
"postal_code": "174029213",
"telephone_number": "717-840-1874",
"fax_number": "717-840-0968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAAG",
"first_name": "JESSICA",
"middle_name": "LYNN",
"name_prefix": "Miss",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-30",
"last_updated": "2013-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT019049",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH AMERICA",
"identifier": "18444",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH UNDER IBC",
"identifier": "0068377000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HGSA PROVIDER NUMBER",
"identifier": "177124",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "332313",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "03182100",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA RR MEDICARE",
"identifier": "CK4276",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.