Jacob Thomas Blong, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11860 Issued in MN

Practice address

1451 Highway 2
Two Harbors, MN 55616-4049

Phone

(218) 834-2586

Fax

(218) 834-2587

NPI assigned

Jun 19, 2020

Last updated

Oct 7, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1053937615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 HIGHWAY 2",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556164049",
            "telephone_number": "218-834-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 HIGHWAY 2",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556164049",
            "telephone_number": "218-834-2586",
            "fax_number": "218-834-2587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14275 Edgewood Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Baxter",
            "state": "MN",
            "postal_code": "564254600",
            "country_code": "US",
            "telephone_number": "218-833-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLONG",
        "first_name": "JACOB",
        "middle_name": "THOMAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-19",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Two Harbors, MN
• Providers in Two Harbors, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.

Verify at the official NPI Registry.