Active NPI
Jakob Logan Porter, DPT, PT
- Physical Therapist
- Herndon, VA
National Provider Identifier
1013832138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305217930
- Practice address
- 13039 Worldgate Dr
Herndon, VA 20170-4374 - Phone
- (703) 689-3164
- Fax
- (703) 689-3167
- NPI assigned
- Aug 10, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305217930 | VA | Primary |
Addresses
Primary practice location
13039 Worldgate Dr
Herndon, VA 20170-4374
Mailing address
12701 Fair Lakes Cir Ste 102
Fairfax, VA 22033-4913
Phone (703) 689-3164
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Clinics Limited Partnership | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Centreville, VA
- NPI 1639594831
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1786320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786665600000",
"number": "1013832138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12701 FAIR LAKES CIR STE 102",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220334913",
"telephone_number": "703-689-3164",
"fax_number": "703-689-3167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13039 WORLDGATE DR",
"city": "HERNDON",
"state": "VA",
"postal_code": "201704374",
"telephone_number": "703-689-3164",
"fax_number": "703-689-3167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "JAKOB",
"middle_name": "LOGAN",
"credential": "DPT, PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-08-10",
"last_updated": "2026-08-14",
"certification_date": "2026-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305217930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Herndon, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.