Individual provider Active NPI

Jennifer L Norris, PT, DPT

  • Physical Therapist
  • Burlington, WI
National Provider Identifier
1619616315
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15781-24 Issued in WI
Practice address
1054 Milwaukee Ave Ste 100
Burlington, WI 53105-1381
Phone
(800) 974-4378
Fax
(630) 515-1536
NPI assigned
Jun 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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 15781-24 WI Primary

Addresses

Primary practice location

1054 Milwaukee Ave Ste 100
Burlington, WI 53105-1381

Mailing address

24014 W Renwick Rd Ste F
Plainfield, IL 60544-8708
Phone (800) 974-4378

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220613001025 WI Practitioner - Physical Therapist in Private Practice 0042698516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DPT Holdings LLCGroup PAC ID 4688679293, 170 clinicians

Practice addresses (Care Compare)

1054 Milwaukee Ave
Suite 200
Burlington, WI 53105-1382
Phone (800) 974-4378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15781-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DPT Holdings PLLC Physical Therapist CurrentSince Jun 6, 2022 Accepting new patients
DPT Holdings LLC CurrentSince Jun 5, 2022 Accepting new patients

Locations

24014 W Renwick Rd
Ste F
Plainfield, IL 60544
Phone (815) 577-2488

1054 Milwaukee Ave
Ste 100
Burlington, WI 53105

1054 Milwaukee Ave
Ste 200
Burlington, WI 53105
Phone 8009744378 ext. 1829

3825 39th Ave
Ste 110
Kenosha, WI 53144
Phone (262) 605-6810

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": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1619616315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24014 W RENWICK RD STE F",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448708",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 MILWAUKEE AVE STE 100",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051381",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15781-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.