Jenny Lynn Pearson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05011733A Issued in IN

Practice address

1201 Cumberland Xing
Valparaiso, IN 46383-2192

Phone

(219) 286-3890

NPI assigned

Oct 29, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rci (WRS), LLC.

  • Physical Therapy Clinic/Center
  • Mishawaka, IN
  • NPI 1619583044

  Physical Therapist

  Medicare reassignment NPD
• Rci (WRS), LLC.

  • Physical Therapy Clinic/Center
  • Demotte, IN
  • NPI 1710593132
  NPD
• Rci (WRS), LLC

  • Physical Therapy Clinic/Center
  • Mokena, IL
  • NPI 1568160950
  NPD
• Waukesha Physical Therapy Clinic

  • Physical Therapist
  • Hartland, WI
  • NPI 1073599783
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1518211697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 S SR 49",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463839790",
            "telephone_number": "219-309-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 CUMBERLAND XING",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832192",
            "telephone_number": "219-286-3890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21075 Swenson Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531862062",
            "country_code": "US",
            "telephone_number": "262-798-8646",
            "fax_number": "262-798-8640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21075 Swenson Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531862062",
            "country_code": "US",
            "telephone_number": "262-798-8646",
            "fax_number": "262-798-8640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "JENNY",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-29",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12214-24",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT.014010",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011733A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "714850269",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicolette Deeanne Paul, M.S.ED, LMHC-A
• Stephen Harry Paul, M.D.
• Pauline Dranger
• Teresa Pavy, MSW/LSW
• Natalie Pearce, MHS, CCC-SLP
• Melitza Peckler, PTA
• Pediatric Dentistry of Northwest Indiana PC
• Pediatric Nursing Specialists of Indiana, Inc.
• Pediatric Therapy Services
• Sara Pedone

• Physical Therapist in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.