John E Jepsen, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501005526 Issued in MI

Practice address

2120 43Rd St SE
Suite 100
Grand Rapids, MI 49508-3772

Phone

(616) 281-1144

Fax

(616) 281-1221

NPI assigned

Apr 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457576886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7126 RIVER GLEN DR SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493168135",
            "telephone_number": "616-891-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 43RD ST SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495083772",
            "telephone_number": "616-281-1144",
            "fax_number": "616-281-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPSEN",
        "first_name": "JOHN",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501005526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMI PROVIDER NUMBER",
            "identifier": "0D15758",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kallie Ann Jensen, RPH
• Nicole Lynn Jensen
• Rachel Jensen
• Noah Jeffrey Jentzen, M.D.
• Joanne Lois Jepsen, ANP-BC
• Beth Ellyn Jepson, LMSW
• Gregory Jereb
• Heather Jereb, M.D.
• Lyric Jerelos
• Jacqueline Mackenzie Jernigan

• Physical Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physical Therapist in Michigan

• 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.