Active NPI
Jaclyn Suzanne Macleod, PT, DPT
- Physical Therapist
- Edgewood, KY
National Provider Identifier
1770919680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 006296
- Practice address
- 560 S Loop Rd
Edgewood, KY 41017-3405 - Phone
- (859) 301-2663
- Fax
- (859) 817-7848
- NPI assigned
- Sep 24, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 006296 | KY | Primary |
Addresses
Primary practice location
560 S Loop Rd
Edgewood, KY 41017-3405
Mailing address
560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663
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
| License | State | Type | Specialty |
|---|---|---|---|
| 006296 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1770919680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 S LOOP RD",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "410173405",
"telephone_number": "859-301-2663",
"fax_number": "859-817-7848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 S LOOP RD",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "410173405",
"telephone_number": "859-301-2663",
"fax_number": "859-817-7848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACLEOD",
"first_name": "JACLYN",
"middle_name": "SUZANNE",
"name_prefix": "Ms.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-24",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "006296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edgewood, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.