Individual provider Active NPI

Kaylee Jawoisz, PT, DPT, ATC

  • Physical Therapist
  • Longmont, CO
National Provider Identifier
1760369508
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0021362 Issued in CO
Practice address
1425 Belmont Dr
Longmont, CO 80503-2358
Phone
(303) 963-5582
NPI assigned
Aug 20, 2025
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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 PTL.0021362 CO Primary

Addresses

Primary practice location

1425 Belmont Dr
Longmont, CO 80503-2358

Mailing address

2517 31St Ave
Rock Island, IL 61201-6315

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250923002521 IL Practitioner - Physical Therapist in Private Practice 6103321039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeform Physical Therapy LLCGroup PAC ID 0941622815, 7 clinicians

Practice addresses (Care Compare)

2906 W Fullerton Ave
Chicago, IL 60647-2921
Phone (773) 698-6659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.029330ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Freeform Physical Therapy LLC Physical Therapist CurrentSince Aug 20, 2025 Accepting new patients

Locations

2070 N Clybourn Ave
Unit F
Chicago, IL 60614
Phone (773) 904-7158

2906 W Fullerton Ave
Chicago, IL 60647
Phone (773) 301-3735

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": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1760369508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2517 31ST AVE",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612016315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 BELMONT DR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805032358",
            "telephone_number": "303-963-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAWOISZ",
        "first_name": "KAYLEE",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-20",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0021362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.