Molly A Jeakle, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501019750 Issued in MI

Practice address

6510 M 66 N
Charlevoix, MI 49720-9272

Phone

(231) 547-0380

Fax

(231) 547-0395

NPI assigned

Oct 26, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Northern Michigan Sports Medicine Center

  • Physical Therapy Clinic/Center
  • Petoskey, MI
  • NPI 1538123906

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1568062016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MERCER BLVD",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201146",
            "telephone_number": "231-675-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 M 66 N",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497209272",
            "telephone_number": "231-547-0380",
            "fax_number": "231-547-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAKLE",
        "first_name": "MOLLY",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karlene Marie Howard, CHW
• Nichole Ivanov, RDH, BS
• Mary A Ivey, M.D.
• James a Gels MD PC
• James Jeakle, M.D.
• William F Jerome, D.D.S, M.S.
• Michael Johnson, CRNA
• Samantha Johnstone
• Tayler Hope Jones, PHARMD
• Dennis M Joy, M.D.

• Physical Therapist in Charlevoix, MI
• Providers in Charlevoix, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.