Individual provider Active NPI

Rachel Jermann, DPT

  • Physical Therapist
  • Verona, WI
National Provider Identifier
1699204529
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13851-24 Issued in WI
Practice address
411 Prairie Heights Dr Ste 101
Verona, WI 53593-2238
Phone
(608) 848-6628
Fax
(608) 848-6629
NPI assigned
Jun 5, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 13851-24 WI Primary

Addresses

Primary practice location

411 Prairie Heights Dr Ste 101
Verona, WI 53593-2238

Mailing address

411 Prairie Heights Dr Ste 101
Verona, WI 53593-2238
Phone (608) 848-6628

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220302002442 TX Practitioner - Physical Therapist in Private Practice 3274899687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kodiak Area Native AssociationGroup PAC ID 8426959297, 36 clinicians

Practice addresses (Care Compare)

3449 E Rezanof Dr
Alutiiq Enwia
Kodiak, AK 99615-6952
Phone (907) 486-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13851-24WIMDPhysical Therapist
52998CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Capitol Physical Therapy LLC Physical Therapist CurrentSince Jul 24, 2022 Accepting new patients
Kodiak Area Native Association CurrentSince Jun 29, 2022 Accepting new patients

Locations

1247 Mill Bay Rd
Ste B
Kodiak, AK 99615

1247 Mill Bay Rd
Unit Bc
Kodiak, AK 99615
Phone (907) 486-9800

3449 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 486-9800

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, 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": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699204529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 PRAIRIE HEIGHTS DR STE 101",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535932238",
            "telephone_number": "608-848-6628",
            "fax_number": "608-848-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 PRAIRIE HEIGHTS DR STE 101",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535932238",
            "telephone_number": "608-848-6628",
            "fax_number": "608-848-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERMANN",
        "first_name": "RACHEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13851-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.