Individual provider Active NPI

Jennifer Widell Vetter, P.T., OCS

  • Physical Therapist
  • Indianapolis, IN
National Provider Identifier
1871750570
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05014443A Issued in IN
Practice address
426 S Alabama St Ste 200
Indianapolis, IN 46225-3301
Phone
(317) 528-6804
Fax
(317) 528-3781
NPI assigned
May 20, 2008
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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 05014443A IN Primary
Physical Therapist 225100000X 3577 OR

Addresses

Primary practice location

426 S Alabama St Ste 200
Indianapolis, IN 46225-3301

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

525 N Santiam Hwy
Lebanon, OR 97355-4363
Phone (541) 451-7125 ext. 7980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211002237 IN Practitioner - Physical Therapist in Private Practice 3173059359 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05014443AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Dec 12, 2024 Accepting new patients
Franciscan Physician Network CurrentSince Dec 12, 2024 Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1703 W Stones Crossing Rd
Ste 120
Greenwood, IN 46143
Phone (317) 528-2018

426 S Alabama St
Ste 200
Indianapolis, IN 46225
Phone (317) 528-2489

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1871750570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 S ALABAMA ST STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462253301",
            "telephone_number": "317-528-6804",
            "fax_number": "317-528-3781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 N Santiam Hwy",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OR",
            "postal_code": "973554363",
            "country_code": "US",
            "telephone_number": "541-451-7125 x7980",
            "fax_number": "541-451-7589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VETTER",
        "first_name": "JENNIFER",
        "middle_name": "WIDELL",
        "name_prefix": "Mrs.",
        "credential": "P.T., OCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05014443A",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3577",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.