Active NPI
Jacob Flynn
- Physical Therapist
- La Crosse, WI
National Provider Identifier
1508778085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17204-24
- Practice address
- 116 20TH St S
La Crosse, WI 54601-4214 - Phone
- (906) 361-7146
- NPI assigned
- Sep 21, 2026
- Last updated
- Sep 21, 2026
- Sex
- Male
- 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 | 17204-24 | WI | Primary |
Addresses
Primary practice location
116 20TH St S
La Crosse, WI 54601-4214
Mailing address
116 20TH St S
La Crosse, WI 54601-4214
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789948800000",
"number": "1508778085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 20TH ST S",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546014214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 20TH ST S",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546014214",
"telephone_number": "906-361-7146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLYNN",
"first_name": "JACOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-21",
"last_updated": "2026-09-21",
"certification_date": "2026-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "17204-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.