Individual provider Active NPI

Karrie L. Jacobsen, B.S., P.T.

  • Physical Therapist
  • Ann Arbor, MI
National Provider Identifier
1457505463
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501006495 Issued in MI
Practice address
5245 Jackson Rd Ste A2
Ann Arbor, MI 48103-1870
Phone
(877) 552-2996
Fax
(866) 245-8064
NPI assigned
Nov 5, 2008
Last updated
Nov 5, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501006495 MI Primary

Addresses

Primary practice location

5245 Jackson Rd Ste A2
Ann Arbor, MI 48103-1870

Mailing address

PO Box 3497
Sturtevant, WI 53177-3497
Phone (888) 201-1040

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
5501006495MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sport and Spine Physical Therapy and Rehab Specialists Physical Therapist Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225843200000",
    "number": "1457505463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3497",
            "city": "STURTEVANT",
            "state": "WI",
            "postal_code": "531773497",
            "telephone_number": "888-201-1040",
            "fax_number": "866-245-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5245 JACKSON RD STE A2",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481031870",
            "telephone_number": "877-552-2996",
            "fax_number": "866-245-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "KARRIE",
        "middle_name": "L.",
        "credential": "B.S., P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2008-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501006495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.