Active NPI
Jessica Evenson
- Physical Therapist
- Aberdeen, SD
National Provider Identifier
1821240862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1288
- Practice address
- 305 S State St
Aberdeen, SD 57401-4527 - Phone
- (605) 622-5000
- Fax
- (605) 622-5255
- NPI assigned
- Oct 22, 2008
- Last updated
- Oct 22, 2008
- 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 | 1288 | SD | Primary |
Addresses
Primary practice location
305 S State St
Aberdeen, SD 57401-4527
Mailing address
37370 132ND St
Mina, SD 57451-5609
Phone (605) 622-5000
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1288 | SD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224633600000",
"number": "1821240862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37370 132ND ST",
"city": "MINA",
"state": "SD",
"postal_code": "574515609",
"telephone_number": "605-622-5000",
"fax_number": "605-622-5255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 S STATE ST",
"city": "ABERDEEN",
"state": "SD",
"postal_code": "574014527",
"telephone_number": "605-622-5000",
"fax_number": "605-622-5255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVENSON",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-22",
"last_updated": "2008-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SD",
"license": "1288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aberdeen, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.