NPIMap

Organization Active NPI

Peter John Jacques

  • Physical Therapist
  • Appleton, WI
National Provider Identifier
1952597486
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3448024 Issued in WI
Legal business name
PETER JOHN JACQUES
Practice address
W4652 Glenn St
Appleton, WI 54913-9563
Phone
(920) 540-8840
Fax
(866) 878-1996
NPI assigned
Sep 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Authorized official

Name
Mr. Peter John Jacques, PTNPI 1699717520
Title
Owner Ceo
Phone
(920) 540-8840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 3448024 WI Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

W4652 Glenn St
Appleton, WI 54913-9563

Mailing address

W4652 Glenn St
Appleton, WI 54913-9563
Phone (920) 540-8840

Other identifiers 1

IdentifierTypeStateIssuer
41750700MedicaidWI

Other names 1

  • Walking and Wheeling LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359504000000",
    "number": "1952597486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W4652 GLENN ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139563",
            "telephone_number": "920-540-8840",
            "fax_number": "866-878-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W4652 GLENN ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139563",
            "telephone_number": "920-540-8840",
            "fax_number": "866-878-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER JOHN JACQUES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2013-01-30",
        "status": "A",
        "authorized_official_last_name": "JACQUES",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "920-540-8840",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3448024",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41750700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walking and Wheeling LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.