Individual provider Active NPI

Jennifer L De Haan, PT

  • Physical Therapist
  • Ocala, FL
National Provider Identifier
1730490871
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT16524 Issued in FL
Practice address
1501 SE 24TH Rd
Ocala, FL 34471-6005
Phone
(352) 629-8900
NPI assigned
Jun 23, 2010
Last updated
Nov 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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 PT16524 FL Primary

Addresses

Primary practice location

1501 SE 24TH Rd
Ocala, FL 34471-6005

Mailing address

1725 SE 5TH St
Ocala, FL 34471-2509
Phone (352) 622-1529

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221027001982 FL Practitioner - Physical Therapist in Private Practice 2961879382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Next PT Group Florida, LLCGroup PAC ID 3173865607, 43 clinicians

Practice addresses (Care Compare)

1661 SE 31St St Unit
3 Marion Woods
Ocala, FL 34471-0741
Phone (850) 380-4657

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT16524FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Next PT Group Florida, LLC Physical Therapist CurrentSince Sep 18, 2022 Accepting new patients

Locations

1661 SE 31st St
Unit 3
Ocala, FL 34471
Phone (850) 380-4657

Organizations & group practices 1

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": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1730490871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 SE 5TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344712509",
            "telephone_number": "352-622-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SE 24TH RD",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344716005",
            "telephone_number": "352-629-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE HAAN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT16524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.