Hailey Dawn Jahnel, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11-06122 Issued in MO

Practice address

24007 Business Highway 71
Maryville, MO 64468-8235

Phone

(660) 235-0002

Fax

(660) 224-0108

NPI assigned

Jun 7, 2019

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 2

Other names 1

• Hailey Dawn Roush Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Reign Physical Therapy LLC

  • Physical Therapist
  • Maryville, MO
  • NPI 1235882614
  NPD

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1518526102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24007 BUSINESS HIGHWAY 71",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644688235",
            "telephone_number": "660-235-0002",
            "fax_number": "660-224-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24007 BUSINESS HIGHWAY 71",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644688235",
            "telephone_number": "660-235-0002",
            "fax_number": "660-224-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAHNEL",
        "first_name": "HAILEY",
        "middle_name": "DAWN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-06127",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "03485",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "11-06122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "11-06122",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "3946",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAILEY",
            "last_name": "ROUSH",
            "middle_name": "DAWN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Maryville, MO
• Providers in Maryville, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.