1275176638 NPI number — JESSICA ARYN VAN HORN PT, DPT, MS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275176638 NPI number — JESSICA ARYN VAN HORN PT, DPT, MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VAN HORN
Provider First Name:
JESSICA
Provider Middle Name:
ARYN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT, MS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WEISS
Provider Other First Name:
JESSICA
Provider Other Middle Name:
ARYN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT, MS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1275176638
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
575 RILEY HOSPITAL DR STE 1372
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46202-5272
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-944-8211
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11725 ILLINOIS ST STE 450
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARMEL
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46032-3010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-944-2353
Provider Business Practice Location Address Fax Number:
317-944-2390
Provider Enumeration Date:
10/17/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT018348 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 05014146A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 300118194 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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