Jeremy Mozak

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

001415 Issued in IA

Practice address

206 Port Neal Rd
Sergeant Bluff, IA 51054-8098

Phone

(712) 943-3837

NPI assigned

Oct 24, 2013

Last updated

Oct 24, 2013By 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)

Not enrolled

State licenses

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1861820060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 PORT NEAL RD",
            "city": "SERGEANT BLUFF",
            "state": "IA",
            "postal_code": "510548098",
            "telephone_number": "712-943-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 PORT NEAL RD",
            "city": "SERGEANT BLUFF",
            "state": "IA",
            "postal_code": "510548098",
            "telephone_number": "712-943-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOZAK",
        "first_name": "JEREMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-24",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IA",
            "license": "001415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Live Young Medical LLC
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• Linda Kay Nelson, PTA
• Nissen Family Chiropractic PC
• Lyle D Nissen, D.C.
• Grant Michael Nobles, D.C.
• Oluwatoyin Adebanke Oyerinde, RN

• Physical Therapy Assistant in Sergeant Bluff, IA
• Providers in Sergeant Bluff, IA by specialty
• Physical Therapy Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.