Individual provider Active NPI

Jordyn Leigh Gleason, PT, DPT

  • Physical Therapist
  • Grand Island, NE
National Provider Identifier
1861276768
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4558 Issued in NE
Practice address
3537 W 13TH St Ste 104
Grand Island, NE 68803-3322
Phone
(308) 382-9700
Fax
(308) 382-9898
NPI assigned
Aug 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4558 NE Primary
Physical Medicine & Rehabilitation Physician 208100000X 4558 NE

Addresses

Primary practice location

3537 W 13TH St Ste 104
Grand Island, NE 68803-3322

Mailing address

929 S Locust St
Grand Island, NE 68801-6751
Phone (308) 382-9700

Other practice location 1

929 S Locust St
Grand Island, NE 68801-6751
Phone (308) 382-9700

Other names 1

  • Miss Jordyn Leigh Grabowski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230912002837 NE Practitioner - Physical Medicine and Rehabilitation 9032573803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Live Well Physical TherapyGroup PAC ID 6800984592, 10 clinicians

Practice addresses (Care Compare)

3537 W 13TH St
Suite 104
Grand Island, NE 68803-3322
Phone (308) 382-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4558NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Live Well Physical Therapy CurrentSince Sep 8, 2023 Accepting new patients

Locations

3537 W 13th St
Ste 104
Grand Island, NE 68803
Phone (308) 382-9700

929 S Locust St
Grand Island, NE 68801
Phone (308) 382-9700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1861276768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 S LOCUST ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688016751",
            "telephone_number": "308-382-9700",
            "fax_number": "308-382-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 W 13TH ST STE 104",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688033322",
            "telephone_number": "308-382-9700",
            "fax_number": "308-382-9898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 S Locust St",
            "address_purpose": "LOCATION",
            "city": "Grand Island",
            "state": "NE",
            "postal_code": "688016751",
            "country_code": "US",
            "telephone_number": "308-382-9700",
            "fax_number": "308-382-9898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "JORDYN",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4558",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NE",
            "license": "4558",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDYN",
            "last_name": "GRABOWSKI",
            "middle_name": "LEIGH",
            "prefix": "MISS",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.