Active NPI
Jo Mary Cowan, PT
- Physical Therapist
- Eau Claire, WI
National Provider Identifier
1972665685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2772-024
- Practice address
- 1405 Truax Blvd
Eau Claire, WI 54703-1474 - Phone
- (715) 552-1030
- Fax
- (715) 552-1033
- NPI assigned
- Dec 16, 2006
- Sex
- Female
- 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 | 2772-024 | WI | Primary |
Addresses
Primary practice location
1405 Truax Blvd
Eau Claire, WI 54703-1474
Mailing address
1405 Truax Blvd
Eau Claire, WI 54703-1474
Phone (715) 552-1030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40464200 | Medicaid | WI |
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 |
|---|---|---|---|
| 2772-024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1972665685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 TRUAX BLVD",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547031474",
"telephone_number": "715-552-1030",
"fax_number": "715-552-1033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 TRUAX BLVD",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547031474",
"telephone_number": "715-552-1030",
"fax_number": "715-552-1033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COWAN",
"first_name": "JO",
"middle_name": "MARY",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-16",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "2772-024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40464200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.