Active NPI
Nancy Jo Weber, PT
- Physical Therapist
- Vermillion, SD
National Provider Identifier
1699715219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1407
- Practice address
- 1407 E Cherry St
Vermillion, SD 57069-2602 - Phone
- (605) 624-7246
- Fax
- (605) 624-7177
- NPI assigned
- Jun 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1407 | SD | Primary |
Addresses
Primary practice location
1407 E Cherry St
Vermillion, SD 57069-2602
Mailing address
1407 E Cherry St
Vermillion, SD 57069-2602
Phone (605) 624-7246
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9260355 | Other | SD | DAKOTACARE |
| 4992211 | Other | SD | SOUTH DAKOTA BLUE CROSS BLUE SHIELD |
| 19685 | Other | SD | AVERA |
Other names 1
- Nancy Jo Johnson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3835 Supreme CT NW
Suite 2
Bemidji, MN 56601-4485
Phone (218) 444-8280
Merit-based Incentive Payment System (MIPS)
- Final score
- 83 of 100
- Quality
- 80
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1407 | SD | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choice Therapy, P.a. | Physical Therapist | Current | Accepting new patients |
| Great Plains Therapy LLC | Physical Therapist | Past | Accepting new patients |
| Multi Care Physicians Group PC | Past | Accepting new patients |
Locations
118 Central St W
Bagley, MN 56621
Phone (218) 694-3030
3835 Supreme Ct NW
Ste 2
Bemidji, MN 56601
Phone (218) 441-5232
Organizations & group practices 3
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.
-
- Physical Therapy Clinic/Center
- Vermillion, SD
- NPI 1174712707
Physical Therapist
-
- Occupational Health Chiropractor
- Sioux City, IA
- NPI 1457369639
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217203200000",
"number": "1699715219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1407 E CHERRY ST",
"city": "VERMILLION",
"state": "SD",
"postal_code": "570692602",
"telephone_number": "605-624-7246",
"fax_number": "605-624-7177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1407 E CHERRY ST",
"city": "VERMILLION",
"state": "SD",
"postal_code": "570692602",
"telephone_number": "605-624-7246",
"fax_number": "605-624-7177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBER",
"first_name": "NANCY",
"middle_name": "JO",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-08",
"last_updated": "2008-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SD",
"license": "1407",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAKOTACARE",
"identifier": "9260355",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTH DAKOTA BLUE CROSS BLUE SHIELD",
"identifier": "4992211",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVERA",
"identifier": "19685",
"state": "SD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "NANCY",
"last_name": "JOHNSON",
"middle_name": "JO",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Vermillion, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.