Jacob P Retzer, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12971 Issued in MT

Practice address

1615 Capitol Way
Bismarck, ND 58501-2218

Phone

(701) 451-0410

NPI assigned

Jun 9, 2017

Last updated

Nov 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Unbound Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Bismarck, ND
  • NPI 1548913361
  NPD Authorized official
• Innovative Therapy Solutions & Consulting LLC

  • Occupational Therapist
  • Mandan, ND
  • NPI 1730700824

  Physical Therapist

  NPD
• Little Lights Pediatric Therapy, LLC

  • Occupational Therapist
  • Bismarck, ND
  • NPI 1083121792

  Physical Therapist

  NPD
• Milestones Therapy, LLC

  • Speech-Language Pathologist
  • Bismarck, ND
  • NPI 1366909251
  NPD (past)

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1821527003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 CAPITOL WAY",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585012218",
            "telephone_number": "701-451-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 CAPITOL WAY",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585012218",
            "telephone_number": "701-451-0410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 1st Ave W",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599014834",
            "country_code": "US",
            "telephone_number": "406-257-5610",
            "fax_number": "406-752-2367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RETZER",
        "first_name": "JACOB",
        "middle_name": "P",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-09",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "12971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renu Longevity PC (Moos Family Chiropractic)
• Brittany Kaye Renz-Wood
• Brielle Mary Renz, DMD
• Carmen Rae Repnow, OT
• Ariana Retuta
• Tawniel Retzlaff
• Revolution Speech Therapy
• Ricardo Jose Reyes, PHARMD
• John T Reynolds, MD
• Robert Ray Reynolds, M.D.

• Physical Therapist in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.