=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043160856
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENESSA ANN CARPENTER DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2026
-----------------------------------------------------
Last Update Date | 01/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3440 MULBERRY AVE
-----------------------------------------------------
City | MUSCATINE
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52761-2323
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 563-263-2197
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23669 HIGHWAY 92
-----------------------------------------------------
City | COLUMBUS JUNCTION
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52738-9591
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-237-2363
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------