Active NPI
Jordan Kershaw, D.P.T.
- Physical Therapist
- Kearney, NE
National Provider Identifier
1487026092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3487
- Practice address
- 3219 Central Ave
Suite 105
Kearney, NE 68847-2949 - Phone
- (308) 865-7182
- Fax
- (308) 865-2881
- NPI assigned
- Oct 21, 2015
- Sex
- Male
- 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 | 3487 | NE | Primary |
Addresses
Primary practice location
3219 Central Ave
Suite 105
Kearney, NE 68847-2949
Mailing address
PO Box 5285
Grand Island, NE 68802-5285
Phone (308) 382-0344
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3487 | NE | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452470400000",
"number": "1487026092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5285",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688025285",
"telephone_number": "308-382-0344",
"fax_number": "308-382-3241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3219 CENTRAL AVE",
"address_2": "SUITE 105",
"city": "KEARNEY",
"state": "NE",
"postal_code": "688472949",
"telephone_number": "308-865-7182",
"fax_number": "308-865-2881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERSHAW",
"first_name": "JORDAN",
"name_prefix": "Mr.",
"credential": "D.P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-10-21",
"last_updated": "2016-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "3487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kearney, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.