Individual provider Active NPI

Jenny Marie Reeve, P.T.

  • Physical Therapist
  • Bloomfield, CT
National Provider Identifier
1902049950
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008515 Issued in CT
Practice address
693 Bloomfield Ave
Bloomfield, CT 06002-2489
Phone
(860) 242-8427
Fax
(860) 242-4147
NPI assigned
Apr 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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 008515 CT Primary

Addresses

Primary practice location

693 Bloomfield Ave
Bloomfield, CT 06002-2489

Mailing address

29 Bishop Rd
West Hartford, CT 06119-1503
Phone (860) 967-9919

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200302001996 WA Practitioner - Physical Therapist in Private Practice 1951452655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19505 7TH Ave NE
Poulsbo, WA 98370-7700
Phone (360) 779-3777

2400 NW Myhre Rd
Silverdale, WA 98383-7672
Phone (360) 613-1834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008515CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Jan 1, 2020 Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Jan 1, 2020 Accepting new patients

Locations

2400 NW Myhre Rd
Ste 101
Silverdale, WA 98383
Phone (360) 598-3764

2400 NW Myhre Rd
Ste 102
Silverdale, WA 98383
Phone (360) 598-3764

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1902049950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 BISHOP RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191503",
            "telephone_number": "860-967-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "693 BLOOMFIELD AVE",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022489",
            "telephone_number": "860-242-8427",
            "fax_number": "860-242-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVE",
        "first_name": "JENNY",
        "middle_name": "MARIE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-07",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.