Jerold Elsen

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

5072-146 Issued in WI

Practice address

231 Walnut St
Spooner, WI 54801-1322

Phone

(712) 635-9791

NPI assigned

Jan 10, 2016

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 10, 2016.

{
    "created_epoch": "1452384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452384000000",
    "number": "1972969723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 SCRIBNER ST",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548011196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 WALNUT ST",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548011322",
            "telephone_number": "712-635-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSEN",
        "first_name": "JEROLD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-10",
        "last_updated": "2016-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "5072-146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Louise Dittmann
• Tasha Draves
• Joshua Eernisse, OD
• Nathan Karl Eichhorst, OD
• Allen Daniel Eli, PTA
• Beth A Emerson, PT
• Evergreen Holistic Healing LLC
• Renita J Flood, OTR
• Anne M. Focht, LCSW
• Leah Foley

• All providers in Spooner, WI
• Massage Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2016; 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.