Jamie Danielle Hardenburg, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502004015 Issued in MI

Practice address

2671 Mount Forest Rd
Bentley, MI 48613-9650

Phone

(989) 903-9196

NPI assigned

Aug 24, 2018

Last updated

Jan 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jamie Danielle Gerow Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1417438730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2671 MOUNT FOREST RD",
            "city": "BENTLEY",
            "state": "MI",
            "postal_code": "486139650",
            "telephone_number": "989-313-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2671 MOUNT FOREST RD",
            "city": "BENTLEY",
            "state": "MI",
            "postal_code": "486139650",
            "telephone_number": "989-903-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDENBURG",
        "first_name": "JAMIE",
        "middle_name": "DANIELLE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502004015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jgerow@mcc.edu",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2671 Mount Forest Rd",
            "city": "Bentley",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486139650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "GEROW",
            "middle_name": "DANIELLE",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kim Clymer, PTA
• Megean Porsch
• Haley Anne Shoultes

• Physical Therapy Assistant in Bentley, MI
• Providers in Bentley, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.