Jennifer Elizabeth Guillen, DPT, ATC/L, CSCS

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

05011192A Issued in IN

Practice address

12800 Missippi Parkway
Suite A101
Crown Point, IN 46307

Phone

(219) 662-5778

NPI assigned

Sep 18, 2013

Sex

Female

Sole proprietor

Yes

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": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1538595806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8759 CLARK PL",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 MISSIPPI PARKWAY",
            "address_2": "SUITE A101",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "46307",
            "telephone_number": "219-662-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLEN",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "DPT, ATC/L, CSCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-18",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IN",
            "license": "05011192A",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36002055A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grounded Therapy LLC
• Domingo Grullon Jr., DPT
• Lindsay Grzymski, MS, CF-SLP
• Rafael Madayag Guanzon, OTR
• Nicole K Guido, MSW, LSW
• Evalisa Gutierrez
• John A. Guzzo, M.D.
• Christina Ha, M.D.
• Charles Francis Haberlin, MSW
• Dawn L Hacker, DO

• Orthopedic Physical Therapist in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Orthopedic Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; 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.