Individual provider Active NPI

Jill Krista Johannsen, DPT

  • Physical Therapist
  • Sioux Falls, SD
National Provider Identifier
1659332690
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1122 Issued in SD
Practice address
810 E 23Rd St
Sioux Falls, SD 57105
Phone
(605) 331-5890
Fax
(605) 336-3974
NPI assigned
Mar 29, 2006
Last updated
Nov 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 1122 SD
Physical Therapist 225100000X 1122 SD Primary

Addresses

Primary practice location

810 E 23Rd St
Sioux Falls, SD 57105

Mailing address

810 E 23Rd St
Sioux Falls, SD 57105-2135
Phone (053) 315-8906

Other practice location 1

810 E 23rd St
Sioux Falls, SD 57105
Phone (605) 331-5890

Other identifiers 3

IdentifierTypeStateIssuer
46030609213MedicaidNE
6402180MedicaidSD
393065300MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090408000112 SD Practitioner - Physical Therapist in Private Practice 3375690431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Institute PCGroup PAC ID 1254223894, 57 clinicians

Practice addresses (Care Compare)

1101 Broadway Ave
Yankton, SD 57078-2835
Phone (605) 331-5890

2120 Live Stronger St
Tea, SD 57064-8331
Phone (605) 331-5890

4600 S Tennis LN
Sioux Falls, SD 57106-2244
Phone (605) 331-5890

810 E 23Rd St
Sioux Falls, SD 57105-2135

Merit-based Incentive Payment System (MIPS)

Final score
83.01 of 100Reported as group
Quality
78.63
Promoting interoperability
100
Improvement activities
40
Cost
64.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1122SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Institute PC CurrentSince Jan 1, 2019 Accepting new patients

Locations

2908 E 26th St
Sioux Falls, SD 57103
Phone (605) 336-2638

810 E 23rd St
Sioux Falls, SD 57105
Phone (605) 339-6823

2120 Live Stronger St
Tea, SD 57064
Phone (605) 982-9545

Interoperability endpoints

  • Direct secure messaging: jill.johannsen.1@21545.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1659332690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 E 23RD ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052135",
            "telephone_number": "053-315-8906",
            "fax_number": "605-336-3974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E 23RD ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57105",
            "telephone_number": "605-331-5890",
            "fax_number": "605-336-3974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 E 23rd St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "57105",
            "country_code": "US",
            "telephone_number": "605-331-5890",
            "fax_number": "605-336-3974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHANNSEN",
        "first_name": "JILL",
        "middle_name": "KRISTA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SD",
            "license": "1122",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "1122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46030609213",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6402180",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "393065300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.