Active NPI
Jacob Ozment
- Physical Therapist
- White Bear Lake, MN
National Provider Identifier
1912697889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13013
- Practice address
- 3638 Rolling View Dr
White Bear Lake, MN 55110-4926 - Phone
- (715) 310-1313
- NPI assigned
- May 12, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 13013 | MN | Primary |
Addresses
Primary practice location
3638 Rolling View Dr
White Bear Lake, MN 55110-4926
Mailing address
3638 Rolling View Dr
White Bear Lake, MN 55110-4926
Phone (715) 310-1313
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683849600000",
"number": "1912697889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3638 ROLLING VIEW DR",
"city": "WHITE BEAR LAKE",
"state": "MN",
"postal_code": "551104926",
"telephone_number": "715-310-1313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3638 ROLLING VIEW DR",
"city": "WHITE BEAR LAKE",
"state": "MN",
"postal_code": "551104926",
"telephone_number": "715-310-1313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OZMENT",
"first_name": "JACOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-12",
"last_updated": "2023-05-12",
"certification_date": "2023-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "13013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Bear Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.