Daryl Clayton Jacobs II, DPT, MTC, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT19737 Issued in FL

Practice address

8045 Spyglass Hill Rd
Suite 103
Melbourne, FL 32940-8567

Phone

(321) 757-5515

NPI assigned

Aug 14, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physical Therapy Professionals LLCGroup PAC ID 2567461825, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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 Therapy Professionals, LLC

  • Physical Therapist
  • Melbourne, FL
  • NPI 1639276900
  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1023021896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8045 SPYGLASS HILL RD",
            "address_2": "SUITE 103",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408567",
            "telephone_number": "321-757-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8045 SPYGLASS HILL RD",
            "address_2": "SUITE 103",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408567",
            "telephone_number": "321-757-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "DARYL",
        "middle_name": "CLAYTON",
        "name_suffix": "II",
        "credential": "DPT, MTC, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT19737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Lee Farson Jackson, APRN
• Jessica Jackson
• Tiye Jackson, PTA
• Valerie P. Jackson, MA
• William Lemar Jackson Jr., MD
• Marielise Jacobs, OTR/L
• Shauna Arnold Jacobs, DPT
• Matthew Warner Jacobson, M.D.
• Amy Jacques
• Samantha M Jaeger

• Physical Therapist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.