Jennie Von Doellen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

302094 Issued in CA

Practice address

1510 W Branch St
Arroyo Grande, CA 93420-1817

Phone

(805) 489-7912

Fax

(805) 489-9697

NPI assigned

Jan 9, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Jennie Walker Former name

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optimum Health and Wellness Physical Therapy IncGroup PAC ID 3870775604, 14 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.

• Optimum Health and Wellness Physical Therapy, Inc.

  • Physical Therapist
  • Ketchikan, AK
  • NPI 1649577578
  Medicare reassignment Care Compare group NPD
• Focus Forward Wellness & Physical Therapy

  • Physical Therapy Clinic/Center
  • Calistoga, CA
  • NPI 1932353034

  Physical Therapist

  NPD (past)
• San Luis Physical Therapy & Orthopedic Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Atascadero, CA
  • NPI 1225046824

  Physical Therapist

  NPD (past)
• San Luis Physical Therapy & Orthopedic Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Pismo Beach, CA
  • NPI 1235147828

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1679343776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HIGUERA ST STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016135",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 W BRANCH ST",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934201817",
            "telephone_number": "805-489-7912",
            "fax_number": "805-489-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON DOELLEN",
        "first_name": "JENNIE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIE",
            "last_name": "WALKER",
            "prefix": "MISS",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victoria S. Roberts, LCSW
• Village Pediatrics of Arroyo Grande, Inc.
• Eva Vink
• Viorela Bauer DDS, Inc
• Dieu Vo
• Anne Vonrueden
• Cynthia Barber Vormbaum, PT
• Voss & Beck Family Dentistry
• Randall Curtis Voss, D.M.D.
• Molly Wagman

• Physical Therapist in Arroyo Grande, CA
• Providers in Arroyo Grande, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.