Active NPI
Nirupama Jacob, PT, CWS
- Physical Therapist
- Muncie, IN
National Provider Identifier
1497737407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05004082A
- Practice address
- 2401 W University Ave
Muncie, IN 47303-3428 - Phone
- (765) 747-3656
- NPI assigned
- Nov 16, 2005
- Sex
- Female
- Sole proprietor
- No
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 | 05004082A | IN | Primary |
Addresses
Primary practice location
2401 W University Ave
Muncie, IN 47303-3428
Mailing address
2401 W University Ave
Muncie, IN 47303-3428
Phone (765) 747-3656
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200332623 | Other | IN | TAX ID |
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 |
|---|---|---|---|
| 05004082A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apex Therapy Services, LLC | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259712000000",
"number": "1497737407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 W UNIVERSITY AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473033428",
"telephone_number": "765-747-3656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 W UNIVERSITY AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473033428",
"telephone_number": "765-747-3656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "NIRUPAMA",
"name_prefix": "Ms.",
"credential": "PT, CWS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-16",
"last_updated": "2009-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05004082A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "200332623",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.