Individual provider Active NPI

Danielle Rose Jacobson, DPT

  • Physical Therapist
  • Watertown, WI
National Provider Identifier
1508366139
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1508 S Church St
Watertown, WI 53094-6404
Phone
(920) 245-3773
NPI assigned
Feb 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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 Primary

Addresses

Primary practice location

1508 S Church St
Watertown, WI 53094-6404

Mailing address

2547 Plainfield Naperville Rd
Ste 152
Naperville, IL 60564-8701
Phone (800) 974-4378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190530000152 WI Practitioner - Physical Therapist in Private Practice 4082957329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DPT Holdings LLCGroup PAC ID 4688679293, 170 clinicians

Practice addresses (Care Compare)

1508 S Church St
Watertown, WI 53094-6404
Phone (800) 974-4378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
DPT Holdings PLLC Physical Therapist CurrentSince Jun 15, 2020 Accepting new patients

Locations

2547 Plainfield Naperville Rd
Ste 152
Naperville, IL 60564
Phone 6304340271 ext. 352

1618 Mehta Ln
Fort Atkinson, WI 53538
Phone (920) 568-9739

540 Village Walk Ln
Ste F
Johnson Creek, WI 53038
Phone (920) 699-9356

3825 39th Ave
Ste 110
Kenosha, WI 53144
Phone (262) 605-6810

1508 S Church St
Watertown, WI 53094
Phone 8009744378 ext. 1948

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": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1508366139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2547 PLAINFIELD NAPERVILLE RD",
            "address_2": "STE 152",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648701",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 S CHURCH ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530946404",
            "telephone_number": "920-245-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "DANIELLE",
        "middle_name": "ROSE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.