Individual provider Active NPI

Jacob Brackett, PT, DPT

  • Physical Therapist
  • Brentwood, TN
National Provider Identifier
1104548668
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14300 Issued in TN
Practice address
500 Wilson Pike Cir Ste 200
Brentwood, TN 37027-3225
Phone
(629) 888-4981
NPI assigned
Sep 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 14300 TN Primary

Addresses

Primary practice location

500 Wilson Pike Cir Ste 200
Brentwood, TN 37027-3225

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230403001816 TN Practitioner - Physical Therapist in Private Practice 3870968985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Results-Ast JV LLCGroup PAC ID 4486066396, 390 clinicians

Practice addresses (Care Compare)

500 Wilson Pike Cir
Suite 200
Brentwood, TN 37027-3225
Phone (629) 888-4981

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14300TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Results-Ast JV, LLC Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

500 Wilson Pike Cir
Ste 200
Brentwood, TN 37027
Phone (629) 888-4981

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

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.

NPI Registry JSON

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1104548668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WILSON PIKE CIR STE 200",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370273225",
            "telephone_number": "629-888-4981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKETT",
        "first_name": "JACOB",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "14300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.