Jordan L. K. Malkowski, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1436 Issued in WY

Practice address

603 S Gillette Ave
Gillette, WY 82716-4205

Phone

(307) 682-2500

Fax

(307) 939-7080

NPI assigned

Oct 15, 2012

Last updated

Jul 28, 2020By the provider in NPPES

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

Enrolled in WY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellhouse LLCGroup PAC ID 3476976044, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wellhouse, LLC

  • Physical Therapist
  • Gillette, WY
  • NPI 1770106668
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1578815551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 S GILLETTE AVE",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827164205",
            "telephone_number": "307-682-2500",
            "fax_number": "307-939-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S GILLETTE AVE",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827164205",
            "telephone_number": "307-682-2500",
            "fax_number": "307-939-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALKOWSKI",
        "first_name": "JORDAN",
        "middle_name": "L. K.",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-15",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "1436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Benton Lutz, M.D.
• Hope Elizabeth Lyon
• Rebecca J Mader, R.N.
• Sherry P. Magnuson, DPT
• Jay Michael Mahylis, LPC
• John L. Mansell, M.D.
• Natasha W Maremma, MD
• J Joseph Marr III, MD
• Dustin Daryl Martinson, PT
• Heather Jean Martinson, PT

• Physical Therapist in Gillette, WY
• Providers in Gillette, WY by specialty
• Physical Therapist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.