Active NPI
Jennifer Dotter, PTA
- Physical Therapy Assistant
- Sugar Grove, IL
National Provider Identifier
1568822344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160006784
- Practice address
- 38 S Main St
Suite a & B
Sugar Grove, IL 60554-5031 - Phone
- (630) 466-5866
- Fax
- (630) 466-5869
- NPI assigned
- Mar 7, 2016
- Last updated
- Mar 7, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160006784 | IL | Primary |
Addresses
Primary practice location
38 S Main St
Suite a & B
Sugar Grove, IL 60554-5031
Mailing address
38 S Main St
Suite a & B, P.O. Box 274
Sugar Grove, IL 60554-5031
Phone (630) 466-5866
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160006784 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457308800000",
"number": "1568822344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 S MAIN ST",
"address_2": "SUITE A & B, P.O. BOX 274",
"city": "SUGAR GROVE",
"state": "IL",
"postal_code": "605545031",
"telephone_number": "630-466-5866",
"fax_number": "630-466-5869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 S MAIN ST",
"address_2": "SUITE A & B",
"city": "SUGAR GROVE",
"state": "IL",
"postal_code": "605545031",
"telephone_number": "630-466-5866",
"fax_number": "630-466-5869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOTTER",
"first_name": "JENNIFER",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-07",
"last_updated": "2016-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160006784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sugar Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.