Active NPI
Jennifer Sergio
- Cardiopulmonary Physical Therapist
- Indianapolis, IN
National Provider Identifier
1629439278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiopulmonary Physical Therapist
- License
- 05006974A
- Practice address
- 1801 N Senate Blvd
MPC 1 Suite 240
Indianapolis, IN 46202-1252 - Phone
- (317) 962-9830
- NPI assigned
- Mar 10, 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 |
|---|---|---|---|---|
| Cardiopulmonary Physical Therapist | 2251C2600X | 05006974A | IN | Primary |
Addresses
Primary practice location
1801 N Senate Blvd
MPC 1 Suite 240
Indianapolis, IN 46202-1252
Mailing address
1801 N Senate Blvd
MPC 1 Suite 240
Indianapolis, IN 46202-1252
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05006974A | IN | MD | Cardiopulmonary Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457568000000",
"number": "1629439278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 N SENATE BLVD",
"address_2": "MPC 1 SUITE 240",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462021252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 N SENATE BLVD",
"address_2": "MPC 1 SUITE 240",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462021252",
"telephone_number": "317-962-9830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERGIO",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-10",
"last_updated": "2016-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "2251C2600X",
"taxonomy_group": "",
"desc": "Physical Therapist, Cardiopulmonary",
"state": "IN",
"license": "05006974A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.