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Walking Sirkos Ocean 320654 Lowa GTX Ladies boots NPI 1689674616 : DR. JENNIFER JACOBSON TURCOTT OD : CUMBERLAND, WI

General Information

NPI Number 1689674616
Entity Type Individual
Provider Name (Legal Business Name) DR. JENNIFER JACOBSON TURCOTT OD

Provider Business Mailing Address

First Line PO BOX 250
Second Line
City CUMBERLAND
State WI
Zip 54829-0250
Country US
Telephone Number 715-822-2091
Fax Number 715-822-3624

Provider Practice Location Address

First Line 1357 2ND AVE
Second Line
City CUMBERLAND
State WI
320654 Walking boots Ocean Lowa Ladies Sirkos GTX Zip 54829-7211
Country US
Telephone Number boots Walking Ladies 320654 Ocean Lowa Sirkos GTX 715-822-2091
Fax Number 715-822-3624

Authorized Official

Title or Position
Name
Credential
Telephone Number

Dates

Provider Enumeration Date 08/01/2005
Last Update Date 12/14/2009

Scope of Practice (Provider's specialty)

Sirkos Lowa GTX Walking 320654 boots Ocean Ladies # Taxonomy Code Taxonomy License Number License Number State
1 Bike 39 6 Womens Newline Shoes US EU 8FHqxw Optometrist WI-2594 WI

Legacy Identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# Identifier Identifier Type Identifier State Identifier Issuer
1 410028306 OTHER WI RR-PTAN 410028306
2 410040876 OTHER WI RR-PTAN 410040876
3 38593200 MEDICAID WI

Proprietary Identifiers Ever Reported

# Identifier Identifier Type Identifier State Identifier Issuer
1 Ladies Sirkos 320654 boots Ocean Lowa GTX Walking 000247425 MEDICARE PIN WI
2 000247430 MEDICARE PIN WI
3 0321190001 MEDICARE NSC Walking boots 320654 Ladies Sirkos Ocean GTX Lowa WI
4 0321190002 MEDICARE NSC WI
5 38593200 MEDICAID WI
6 410028306 OTHER WI RR-PTAN 410028306
7 410040876 OTHER WI RR-PTAN 410040876
8 U53713 MEDICARE UPIN

NPI Data Dissemination. Special Note for Health Care Providers.

In September 2007, CMS began disclosing NPPES health care provider data that are disclosable under the Freedom of Information Act (FOIA) to the public. The FOIA-disclosable data for a health care provider (individual or organization) who deactivated an NPI will now be disclosed within the files. For a deactivated NPI, CMS will only disclose the deactivated NPI and the associated date of deactivation within the files.

The NPI Registry and the downloadable files will contain data from the NPPES as reported to NPPES by you, or by someone acting on your behalf, or by an organization provider's Authorized Official. If the downloadable file or the NPI Registry reflects information that is incorrect, health care providers should correct that information.

At any time, providers, or someone acting on their behalf, may edit their records by going to https://nppes.cms.hhs.gov, or by obtaining a paper NPI Application/Update Form (CMS-10114) from the NPI Enumerator or from the CMS forms page (http://www.cms.gov/Medicare/CMS-Forms/CMS-Forms) and mailing the completed, signed form to the NPI Enumerator. Providers who need assistance in editing their records should contact the NPI Enumerator by phone at 1-800-465-3203, by email customerservice@npienumerator.com, or by letter: NPI Enumerator, P.O. Box 6059, Fargo, ND 58108-6059.

Read more at CMS.GOV
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Reference Data. Full Replica of the NPPES NPI Record.

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# Field Name Value Description
1 NPI 1689674616 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
2 Entity Type Individual Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Is Sole Proprietor N Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
4 Provider Last Name (Legal Name) TURCOTT The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
5 Provider First Name JENNIFER The first name of the provider, if the provider is an individual.
6 Provider Middle Name JACOBSON The middle name of the provider, if the provider is an individual.
7 Provider Name Prefix Text DR. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
8 Provider Credential Text OD The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
9 Provider First Line Business Mailing Address PO BOX 250 The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
10 Provider Business Mailing Address City Name CUMBERLAND The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
11 Provider Business Mailing Address State Name WI The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
12 Provider Business Mailing Address Postal Code 54829-0250 The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
13 Provider Business Mailing Address Country Code US The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
14 Provider Business Mailing Address Telephone Number 715-822-2091 The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
15 Provider Business Mailing Address Fax Number 715-822-3624 The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
16 Provider First Line Business Practice Location Address 1357 2ND AVE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
17 Provider Business Practice Location Address City Name CUMBERLAND The city name in the location address of the provider being identified.
18 Provider Business Practice Location Address State Name WI The State or Province name in the location address of the provider being identified.
19 Provider Business Practice Location Address Postal Code 54829-7211 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
20 Lowa Sirkos Walking boots GTX Ladies 320654 Ocean Provider Business Practice Location Address Country Code US The country code in the location address of the provider being identified.
21 Provider Business Practice Location Address Telephone Number 715-822-2091 The telephone number associated with the location address of the provider being identified.
Ladies 320654 GTX Lowa boots Sirkos Ocean Walking 22 Provider Business Practice Location Address Fax Number boots Ladies GTX 320654 Sirkos Walking Ocean Lowa 715-822-3624 The fax number associated with the location address of the provider being identified.
23 Provider Enumeration Date 08/01/2005 The date the provider was assigned a unique identifier (assigned an NPI).
24 Last Update Date 12/14/2009 The date that a record was last updated or changed.
25 Ocean Sirkos boots GTX Ladies 320654 Lowa Walking Provider Gender Code 320654 Lowa GTX Sirkos boots Ladies Ocean Walking F The code designating the provider's gender if the provider is a person.
26 Sirkos Lowa Ladies Walking 320654 GTX boots Ocean Provider Gender Female The provider's gender if the provider is a person.
27 Healthcare Provider Taxonomy Code #1 152W00000X The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
28 Healthcare Provider Taxonomy 1 Optometrist Healthcare Provider Taxonomy #1
29 Provider License Number 1 WI-2594 Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
30 Provider License Number State Code 1 WI Provider License Number State Code #1
31 Healthcare Provider Primary Taxonomy Switch 1 Y Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
32 Other Provider Identifier 1 410028306 Other Provider Identifier #1
33 Other Provider Identifier Type 1 OTHER Other Provider Identifier Type #1
GTX Ocean 320654 Walking Ladies Lowa boots Sirkos 34 Other Provider Identifier State 1 WI Other Provider Identifier State #1
35 Other Provider Identifier Issuer 1 Walking GTX Lowa Sirkos boots 320654 Ladies Ocean RR-PTAN 410028306 320654 Lowa Sirkos Ladies Walking boots Ocean GTX Other Provider Identifier Issuer #1
36 Other Provider Identifier 2 410040876 Other Provider Identifier #2
37 Other Provider Identifier Type 2 OTHER Other Provider Identifier Type #2
38 Other Provider Identifier State 2 WI Other Provider Identifier State #2
39 Other Provider Identifier Issuer 2 RR-PTAN 410040876 Other Provider Identifier Issuer #2
40 Other Provider Identifier 3 38593200 Other Provider Identifier #3
41 Other Provider Identifier Type 3 MEDICAID Other Provider Identifier Type #3
42 Other Provider Identifier State 3 WI Other Provider Identifier State #3

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