Individual provider Active NPI

Nancy Jo Weber, PT

  • Physical Therapist
  • Vermillion, SD
National Provider Identifier
1699715219
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1407 Issued in SD
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

Updated by the provider on Jul 28, 2008

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 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

IdentifierTypeStateIssuer
9260355OtherSDDAKOTACARE
4992211OtherSDSOUTH DAKOTA BLUE CROSS BLUE SHIELD
19685OtherSDAVERA

Other names 1

  • Nancy Jo Johnson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120213000843 MN Practitioner - Physical Therapist in Private Practice 5092802306 Reassigns benefits to 1 organization

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
Choice Therapy, P.a.Group PAC ID 7618022930, 39 clinicians

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 100Reported as individual
Quality
80
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1407SDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Choice Therapy, P.a. Physical Therapist CurrentSince Aug 4, 2011 Accepting new patients
Great Plains Therapy LLC Physical Therapist PastSince Oct 17, 2005 Accepting new patients
Multi Care Physicians Group PC PastSince Oct 1, 2002 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.

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.

Verify at the official NPI Registry.