Provider Demographics
NPI:1821021452
Name:HAUSMANN, JON J (DPT)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:J
Last Name:HAUSMANN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 8
Mailing Address - Street 2:
Mailing Address - City:PIERCE
Mailing Address - State:NE
Mailing Address - Zip Code:68767
Mailing Address - Country:US
Mailing Address - Phone:402-329-4050
Mailing Address - Fax:402-329-4057
Practice Address - Street 1:105 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PIERCE
Practice Address - State:NE
Practice Address - Zip Code:68767-1343
Practice Address - Country:US
Practice Address - Phone:402-329-4050
Practice Address - Fax:402-329-4057
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2667225100000X
NE1442255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026268100Medicaid
NE10026268102Medicaid
NE10026268101Medicaid