Jacob Steven Laverman

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

05012967A Issued in IN

Practice address

1001 E 17TH St
Bloomington, IN 47408-1590

Phone

(712) 461-0244

NPI assigned

Feb 22, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1528525920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7151 HATTERAS LN APT 1D",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462141267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E 17TH ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474081590",
            "telephone_number": "712-461-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVERMAN",
        "first_name": "JACOB",
        "middle_name": "STEVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-22",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36002972A",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "IN",
            "license": "05012967A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James J Laughlin, MD
• Susan Glenna Laughlin, FNP
• Laura Lininger, LCSW Counseling Services, LLC
• Laura Petersen, M.S.W., L.C.S.W., L.L.C.
• Amanda Lavender, PMHNP
• David Eston Lawler, D.D.S.
• Patricia Lawson-Buckley, LMFT
• Richard Lawson
• Kelly Lazzell, R.D.
• Anne M Leach, M.D.

• Sports Physical Therapist in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Sports Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.