Active NPI
Jon-Ross Jesse Rene Ennest, DPT
- Physical Therapist
- Miamisburg, OH
National Provider Identifier
1962277491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 3449 Newmark Dr
Miamisburg, OH 45342-5426 - Phone
- (937) 281-1286
- NPI assigned
- Nov 15, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT020784 | OH | |
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
3449 Newmark Dr
Miamisburg, OH 45342-5426
Mailing address
1413 Doddington Rd
Dayton, OH 45409-1751
Phone (269) 830-6166
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT020784 | OH | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abc Pediatric Therapy LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- West Chester, OH
- NPI 1134152861
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734566400000",
"number": "1962277491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1413 DODDINGTON RD",
"city": "DAYTON",
"state": "OH",
"postal_code": "454091751",
"telephone_number": "269-830-6166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3449 NEWMARK DR",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453425426",
"telephone_number": "937-281-1286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENNEST",
"first_name": "JON-ROSS",
"middle_name": "JESSE RENE",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-11-15",
"last_updated": "2024-12-19",
"certification_date": "2024-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "OH",
"license": "PT020784",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miamisburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.