Jennifer Lynne Gudakunst, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT.009717 Issued in OH

Practice address

11080 E Gypsy Lane Rd
Bowling Green, OH 43402-9564

Phone

(419) 353-8411

Fax

(419) 352-9403

NPI assigned

Apr 17, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Specialty Physicians of Blanchard Valley LLC

  • Cardiovascular Disease Physician
  • Findlay, OH
  • NPI 1689835415
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437375771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6527 HOLCOMB RD",
            "city": "PEMBERVILLE",
            "state": "OH",
            "postal_code": "434509440",
            "telephone_number": "419-287-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11080 E GYPSY LANE RD",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434029564",
            "telephone_number": "419-353-8411",
            "fax_number": "419-352-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDAKUNST",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT.009717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Leona Grisolono
• Connie Grose
• Theresa M Gross, STNA
• Joshua B. Grubbs, PH.D.
• Kristin Gruhler
• Jenna Guerrero, LISW
• Patricia M Guice, LMT
• Marcleana Rae Haack, APN
• Blayc Hacker
• Karen Sue Hagemeyer, RPH

• Physical Therapist in Bowling Green, OH
• Providers in Bowling Green, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.