Individual provider Active NPI

Jordan M Wimsatt, PT

  • Physical Therapist
  • Cincinnati, OH
National Provider Identifier
1942949029
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP011661T Issued in OH
Practice address
7910 Beechmont Ave
Cincinnati, OH 45255-4210
Phone
(859) 817-3599
NPI assigned
May 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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 CP011661T OH Primary

Addresses

Primary practice location

7910 Beechmont Ave
Cincinnati, OH 45255-4210

Mailing address

560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663

Other practice location 1

8726 US 42
Florence, KY 41042-9625
Phone (859) 301-2663

Other identifiers 2

IdentifierTypeStateIssuer
0003351MedicaidOH
7100819660MedicaidKY

Other names 1

  • Jodan M Maxwell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220819001706 KY Practitioner - Physical Therapist in Private Practice 8921481144 Reassigns benefits to 1 organization
I20221021000471 OH Practitioner - Physical Therapist in Private Practice 8921481144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7910 Beechmont Ave
Cincinnati, OH 45255-4210
Phone (513) 232-2663

8726 US
Suite 42
Florence, KY 41042
Phone (859) 301-2663

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP011661TOHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocincy Orthopaedics & Sports Medicine PSC Physical Therapist CurrentSince May 16, 2022 Accepting new patients
Orthocincy Orthopaedics & Sports Medicine PSC Physical Therapist CurrentSince May 16, 2022 Accepting new patients

Locations

560 S Loop Rd
Edgewood, KY 41017
Phone (859) 817-3599

2123 Auburn Ave
Ste 630
Cincinnati, OH 45219
Phone (513) 585-1970

4355 Ferguson Dr
Cincinnati, OH 45245
Phone (513) 221-2663

7910 Beechmont Ave
Cincinnati, OH 45255
Phone (513) 474-8600

9871 Montgomery Rd
Montgomery, OH 45242

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": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1942949029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173405",
            "telephone_number": "859-301-2663",
            "fax_number": "859-817-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 BEECHMONT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452554210",
            "telephone_number": "859-817-3599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8726 US 42",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410429625",
            "country_code": "US",
            "telephone_number": "859-301-2663",
            "fax_number": "859-817-7848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIMSATT",
        "first_name": "JORDAN",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "CP011661T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0003351",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100819660",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODAN",
            "last_name": "MAXWELL",
            "middle_name": "M",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.