Individual provider Active NPI

Nathan Jacobs

  • Physical Therapist
  • Rock Island, IL
National Provider Identifier
1154878312
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1733 30TH St Ste 104
Rock Island, IL 61201-3745
Phone
(309) 743-0300
NPI assigned
Sep 6, 2016
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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 NU Primary

Addresses

Primary practice location

1733 30TH St Ste 104
Rock Island, IL 61201-3745

Mailing address

850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250313002983 IL Practitioner - Physical Therapist in Private Practice 4082136528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1733 30TH St
Suite 104
Rock Island, IL 61201-3745
Phone (309) 743-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Mar 10, 2025 Accepting new patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Mar 10, 2025 Accepting new patients

Locations

850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070

850 43rd Ave
Ste 300
Moline, IL 61265
Phone (309) 743-0300

1733 30th St
Ste 104
Rock Island, IL 61201
Phone (309) 743-0300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1154878312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE STE 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 30TH ST STE 104",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612013745",
            "telephone_number": "309-743-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "NATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-06",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.