Jacob Randall Ewigman, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11-05960 Issued in KS

Practice address

7925 State Ave
Kansas City, KS 66112-2465

Phone

(913) 334-9930

Fax

(913) 334-9941

NPI assigned

Mar 22, 2019

Last updated

Dec 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Missouri, Columbia School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Serc Rebabilitation Partners, LLCGroup PAC ID 9830344563, 212 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Serc Rehabilitation Partners, LLC

  dba Serc

  • Physical Therapist
  • Belton, MO
  • NPI 1760745244

  KS

  Medicare reassignment Care Compare group NPD
• Serc Rebabilitation Partners, LLC

  • Physical Therapist
  • Overland Park, KS
  • NPI 1598190209
  NPD

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1710447198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7925 STATE AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661122465",
            "telephone_number": "913-334-9930",
            "fax_number": "913-334-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWIGMAN",
        "first_name": "JACOB",
        "middle_name": "RANDALL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-05960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaelyn Aleah Everhart, MD
• Brian Macneille Everist, M.D.
• Katherine Everly, DO
• Adam Taylor Everson, PHD
• Jeffrey A. Evilsizor, PA-C
• Expresscare Medical Services, Inc
• Claire Marie Exum, PA
• Eye Care, LLC (Discover Vision Centers)
• Asal Fahem, MD
• Thomas M Fahrbach, MD

• Physical Therapist in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.