Individual provider Active NPI

Jean E Stephan, PT

  • Physical Therapist
  • Lake Geneva, WI
National Provider Identifier
1730304205
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3209024 Issued in WI
Practice address
N3219 Highway H
Ste 3
Lake Geneva, WI 53147-1074
Phone
(262) 248-9902
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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 3209024 WI Primary

Addresses

Primary practice location

N3219 Highway H
Ste 3
Lake Geneva, WI 53147-1074

Mailing address

N3219 Highway H
Ste 3
Lake Geneva, WI 53147-1074
Phone (262) 248-9902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3209WIMDChiropractor
3209024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakes Area Physical Therapy, LLC Physical Therapist Past Accepting new patients
Hand Rehabilitation Services Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1730304205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N3219 HIGHWAY H",
            "address_2": "STE 3",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471074",
            "telephone_number": "262-248-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N3219 HIGHWAY H",
            "address_2": "STE 3",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471074",
            "telephone_number": "262-248-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHAN",
        "first_name": "JEAN",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3209024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Geneva, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.