Jeanne A Dirksen, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00002165 Issued in WA

Practice address

27 Colwell Street
Port Hadlock, WA 98339

Phone

(360) 385-9310

Fax

(360) 379-8826

NPI assigned

Jul 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dirksen Physical Therapy Inc PS

  • Physical Therapist
  • Port Hadlock, WA
  • NPI 1609890029
  NPD (past) Authorized official
• Discovery Physical Therapy Inc., P.S.

  • Physical Therapy Clinic/Center
  • Port Hadlock, WA
  • NPI 1922104926
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1972521672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 897",
            "city": "PORT HADLOCK",
            "state": "WA",
            "postal_code": "98339",
            "telephone_number": "360-385-9310",
            "fax_number": "360-379-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 COLWELL STREET",
            "city": "PORT HADLOCK",
            "state": "WA",
            "postal_code": "98339",
            "telephone_number": "360-385-9310",
            "fax_number": "360-379-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRKSEN",
        "first_name": "JEANNE",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00002165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "6147DI",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8374688",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WEST",
            "identifier": "A002",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "G8862188",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5812580",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00408657",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Dam, D.C.
• David O. Schores OD Inc PS
• Jeanine Marie Davis, LMHCA
• Dentistry Northwest
• Dirksen Physical Therapy Inc PS
• Discovery Physical Therapy Inc., P.S.
• Doctors Noble Cramer PLLC
• Ann M Failoni, ARNP
• Fred Meyer Stores Inc
• Renaldo Ganir, R.PH.

• Physical Therapist in Port Hadlock, WA
• Providers in Port Hadlock, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.