Individual provider Active NPI

Jennifer Dahlgren, PT, DPT

  • Physical Therapist
  • Fountain Hills, AZ
National Provider Identifier
1568092898
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-30980 Issued in AZ
Practice address
16455 E Avenue of the Fountains
Fountain Hills, AZ 85268-8307
Phone
(480) 837-2023
NPI assigned
Jan 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X LPT-30980 AZ Primary

Addresses

Primary practice location

16455 E Avenue of the Fountains
Fountain Hills, AZ 85268-8307

Mailing address

16455 E Avenue of the Fountains
Fountain Hills, AZ 85268-8307

Other names 1

  • Jennifer Chalanycz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201117001333 AZ Practitioner - Physical Therapist in Private Practice 5395156673 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation, LLC Physical Therapist CurrentSince Aug 13, 2024 Accepting new patients
Empowerme Rehabilitation, LLC Physical Therapist CurrentSince Aug 13, 2024 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1579996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1568092898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16455 E AVENUE OF THE FOUNTAINS",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852688307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16455 E AVENUE OF THE FOUNTAINS",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852688307",
            "telephone_number": "480-837-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLGREN",
        "first_name": "JENNIFER",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-26",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-30980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "CHALANYCZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fountain Hills, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.