Individual provider Active NPI

Jacqueline Ann Siemers, P.T.A.

  • Physical Therapy Assistant
  • Raleigh, NC
National Provider Identifier
1750674669
Registry record updated May 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160.001357 Issued in IL
Practice address
3001 Spring Forest Rd
Raleigh, NC 27616-2815
Phone
(815) 271-5249
Fax
(815) 271-5289
NPI assigned
May 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.001357 IL Primary

Addresses

Primary practice location

3001 Spring Forest Rd
Raleigh, NC 27616-2815

Mailing address

623 Beggs LN Apt 3
Marengo, IL 60152-9366
Phone (815) 596-1111

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
160.001357ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1750674669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 BEGGS LN APT 3",
            "city": "MARENGO",
            "state": "IL",
            "postal_code": "601529366",
            "telephone_number": "815-596-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 SPRING FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162815",
            "telephone_number": "815-271-5249",
            "fax_number": "815-271-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEMERS",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.001357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; 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.