Provider Demographics
NPI:1972752459
Name:CAP, JODI
Entity type:Individual
Prefix:MRS
First Name:JODI
Middle Name:
Last Name:CAP
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:STEMPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1319 W HAVENS AVE
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-4116
Mailing Address - Country:US
Mailing Address - Phone:605-996-4778
Mailing Address - Fax:605-996-3660
Practice Address - Street 1:1319 W HAVENS AVE
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-4116
Practice Address - Country:US
Practice Address - Phone:605-996-4778
Practice Address - Fax:605-996-3660
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS102732Medicare PIN