Individual provider Active NPI

Lisa Marie Jongkind, MSPT

  • Physical Therapist
  • La Porte, IN
National Provider Identifier
1881886521
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05005035A Issued in IN
Practice address
1007 Lincolnway
La Porte, IN 46350-3201
Phone
(219) 326-2391
NPI assigned
Aug 16, 2007
Last updated
Aug 16, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05005035A IN Primary

Addresses

Primary practice location

1007 Lincolnway
La Porte, IN 46350-3201

Mailing address

1007 Lincolnway
La Porte, IN 46350-3201
Phone (219) 324-9214

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
05005035AINMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187222400000",
    "number": "1881886521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 LINCOLNWAY",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503201",
            "telephone_number": "219-324-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 LINCOLNWAY",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503201",
            "telephone_number": "219-326-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONGKIND",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05005035A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; 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.