Active NPI
Jennifer Oaks, PTA
- Physical Therapy Assistant
- Omro, WI
National Provider Identifier
1851982789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3124
- Practice address
- 500 Grant Ave
Omro, WI 54963-1342 - Phone
- (920) 685-2755
- NPI assigned
- Feb 2, 2021
- Last updated
- Feb 2, 2021
- 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 Therapy Assistant | 225200000X | 3124 | WI | Primary |
Addresses
Primary practice location
500 Grant Ave
Omro, WI 54963-1342
Mailing address
N1719 William Dr
Waupaca, WI 54981-9787
Phone (715) 412-2185
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 |
|---|---|---|---|
| 3124 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612224000000",
"number": "1851982789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N1719 WILLIAM DR",
"city": "WAUPACA",
"state": "WI",
"postal_code": "549819787",
"telephone_number": "715-412-2185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 GRANT AVE",
"city": "OMRO",
"state": "WI",
"postal_code": "549631342",
"telephone_number": "920-685-2755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OAKS",
"first_name": "JENNIFER",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-02",
"last_updated": "2021-02-02",
"certification_date": "2021-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "3124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omro, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.