Active NPI
Jacob Carpenter
- Physical Therapy Assistant
- Lincoln, NE
National Provider Identifier
1083570758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1687
- Practice address
- 6611 Vine St
Lincoln, NE 68505-2234 - Phone
- (402) 421-7920
- NPI assigned
- Dec 26, 2025
- 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 Therapy Assistant | 225200000X | 1687 | NE | Primary |
Addresses
Primary practice location
6611 Vine St
Lincoln, NE 68505-2234
Mailing address
6040 S 58TH St
Lincoln, NE 68516-3695
Phone (402) 421-7920
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767052800000",
"number": "1083570758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6040 S 58TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685163695",
"telephone_number": "402-421-7920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6611 VINE ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685052234",
"telephone_number": "402-421-7920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARPENTER",
"first_name": "JACOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-12-26",
"last_updated": "2025-12-30",
"certification_date": "2025-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NE",
"license": "1687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.