Individual provider Active NPI

Jaime Lynn Vanbuskirk, PT, DPT, COMT, CMTPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1659536118
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3938 W 111TH St Ste 1B
Chicago, IL 60655
Phone
(773) 629-6875
Fax
(844) 965-9380
NPI assigned
Jul 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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 Primary

Addresses

Primary practice location

3938 W 111TH St Ste 1B
Chicago, IL 60655

Mailing address

15632 Centennial CT
Orland Park, IL 60462-4571
Phone (773) 718-3814

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110707000592 IL Practitioner - Physical Therapist in Private Practice 1254519630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3938 W 111TH St
Suite 1D
Chicago, IL 60655-4047
Phone (773) 629-6875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
JVB PT, LLC Physical Therapist CurrentSince Mar 20, 2018 Accepting new patients
Core Physical Therapy Clinics, LLC Past Accepting new patients

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": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1659536118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15632 CENTENNIAL CT",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624571",
            "telephone_number": "773-718-3814",
            "fax_number": "844-908-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3938 W 111TH ST STE 1B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60655",
            "telephone_number": "773-629-6875",
            "fax_number": "844-965-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANBUSKIRK",
        "first_name": "JAIME",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PT, DPT, COMT, CMTPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-24",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.