Active NPI
Jacob Adkins
- Physical Therapist
- Saint Joseph, MO
National Provider Identifier
1124706809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT61068020
- Practice address
- 5325 Faraon St
Saint Joseph, MO 64506-3488 - Phone
- (816) 271-6000
- NPI assigned
- Jul 11, 2023
- 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 Therapist | 225100000X | PT61068020 | WA | Primary |
Addresses
Primary practice location
5325 Faraon St
Saint Joseph, MO 64506-3488
Mailing address
2201 NE 94TH CT
Vancouver, WA 98664-2900
Phone (847) 863-0780
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT61068020 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689033600000",
"number": "1124706809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 NE 94TH CT",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986642900",
"telephone_number": "847-863-0780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5325 FARAON ST",
"city": "SAINT JOSEPH",
"state": "MO",
"postal_code": "645063488",
"telephone_number": "816-271-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADKINS",
"first_name": "JACOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-11",
"last_updated": "2023-07-11",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT61068020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Joseph, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.