Individual provider Active NPI

Jacob William Spinka, PT, DPT

  • Physical Therapist
  • Lenexa, KS
National Provider Identifier
1124449137
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-04680 Issued in KS
Practice address
8423 Widmer Rd
Lenexa, KS 66215-5416
Phone
(913) 484-0584
NPI assigned
Dec 17, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT28919 FL
Physical Therapist 225100000X 11-04680 KS Primary

Addresses

Primary practice location

8423 Widmer Rd
Lenexa, KS 66215-5416

Mailing address

8423 Widmer Rd
Lenexa, KS 66215-5416
Phone (913) 484-0584

Other practice location 1

1240 N Broadmoor St
Wichita, KS 67206-3896
Phone (316) 636-5101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231103000651 KS Practitioner - Physical Therapist in Private Practice 2567771520 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

2455 N Woodlawn Blvd
Wichita, KS 67220-3996
Phone (316) 201-4277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-04680KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc. Physical Therapist CurrentSince Nov 20, 2023 Accepting new patients
Creative Health Care Management LLC Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Nov 20, 2023 Accepting new patients

Locations

10 S 9th St
Ste 4
Noblesville, IN 46060

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 4

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": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1124449137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8423 WIDMER RD",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662155416",
            "telephone_number": "913-484-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8423 WIDMER RD",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662155416",
            "telephone_number": "913-484-0584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1240 N Broadmoor St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672063896",
            "country_code": "US",
            "telephone_number": "316-636-5101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPINKA",
        "first_name": "JACOB",
        "middle_name": "WILLIAM",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-17",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28919",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-04680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenexa, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; 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.