Jennifer Lake, DPT, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT018511 Issued in OH

Practice address

112 Harcourt Rd
Mount Vernon, OH 43050-3946

Phone

(740) 392-8811

NPI assigned

Mar 11, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rehabilitative Associates IncGroup PAC ID 4880598663, 9 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 and National Provider Directory roles.

• Rehabilitative Associates Inc

  • Occupational Therapist
  • Pickerington, OH
  • NPI 1770672099

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Rehabilitative Associates, Inc

  • Physical Therapist
  • Mansfield, OH
  • NPI 1679742720
  NPD
• Mohican Therapy Group

  • Physical Therapist
  • Marysville, OH
  • NPI 1174795397
  NPD (past)

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1669007597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HARCOURT RD STE 1",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HARCOURT RD",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503946",
            "telephone_number": "740-392-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "JENNIFER",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-11",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "PT018511",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT018511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Kroninger
• Ashley Kuhn, CDCA
• Darlene Lynn Kurth, LSW
• Paula Kyle-Stephens
• Laura Labenne
• Yamrote Lakew, RPH RN
• Karma K Lamb, LPCC, LCDCIII
• Lane Drug Co
• Alanna Jeannine Lane, S.T.N.A.
• Katherine Dawn Lane

• Physical Therapist in Mount Vernon, OH
• Providers in Mount Vernon, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.