MEDICARE: ARIANA ADRIENNE JACOBSEN PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	11-05678	KS

General Provider Information

NPI Number	:	1275061962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANA ADRIENNE JACOBSEN PT, DPT

Provider Business Mailing Address
First Line	:	12452 S GALLERY ST
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-6096
Country	:	US
Telephone Number	:	913-526-4434
Fax Number	:

Provider Business Practice Location Address
First Line	:	3627 SE 29TH ST STE 107
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66605-2013
Country	:	US
Telephone Number	:	785-266-4600
Fax Number	:	785-266-4601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2017
Last Update Date	:	06/18/2026

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