Individual provider Active NPI

Jenna Larue, PT, DPT

  • Physical Therapist
  • Louisville, KY
National Provider Identifier
1508559808
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-009048 Issued in KY
Practice address
1227 Goss Ave
Louisville, KY 40217-1239
Phone
(502) 636-1200
NPI assigned
Jun 1, 2023
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT020577 OH
Physical Therapist 225100000X PT-009048 KY Primary

Addresses

Primary practice location

1227 Goss Ave
Louisville, KY 40217-1239

Mailing address

6156 Southampton Dr
Dayton, OH 45459-1913
Phone (937) 776-3412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230714000388 OH Practitioner - Physical Therapist in Private Practice 4688034291 Reassigns benefits to 1 organization
I20240903004118 KY Practitioner - Physical Therapist in Private Practice 4688034291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SN Kentuckiana Rehab, LLCGroup PAC ID 1254671464, 339 clinicians

Practice addresses (Care Compare)

1227 Goss Ave
Louisville, KY 40217-1239
Phone (502) 636-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-009048KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
SN Kentuckiana Rehab, LLC CurrentSince Jul 8, 2024 Accepting new patients
Ohrh, LLC Physical Therapist CurrentSince Jun 19, 2023 Accepting new patients
Ohrh, LLC CurrentSince Jun 19, 2023 Accepting new patients
SN Kentuckiana Rehab, LLC Physical Therapist Current Accepting new patients
Ohrh, LLC Current Accepting new patients
SN Kentuckiana Rehab, LLC CurrentSince Jul 8, 2024 Accepting new patients

Locations

1227 Goss Ave
Louisville, KY 40217
Phone (502) 636-1200

210 E Gray St
Ste 807
Louisville, KY 40202
Phone (502) 587-9350

6021 Cleveland Ave
Columbus, OH 43231
Phone (614) 895-1090

6465 E Broad St
Ste B
Columbus, OH 43213
Phone (614) 863-1089

561 W Central Ave
Delaware, OH 43015
Phone (614) 566-9983

Organizations & group practices 6

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": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1508559808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6156 SOUTHAMPTON DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454591913",
            "telephone_number": "937-776-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 GOSS AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171239",
            "telephone_number": "502-636-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARUE",
        "first_name": "JENNA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-01",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT020577",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "PT-009048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.