Jacob Matthew Anderson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070018144 Issued in IL

Practice address

767 30TH Street
Rock Island, IL 61201

Phone

(309) 788-7631

NPI assigned

Dec 19, 2013

Last updated

Jun 24, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• St Anthonys Rehabilitation and Nursing Center LLC

  dba St Anthonys NSG and Rehab Ctr

  • Skilled Nursing Facility
  • Rock Island, IL
  • NPI 1407598865

  Physical Therapist

  Medicare reassignment NPD
• At Home by Enhance Therapies LLC

  • Physical Therapist
  • Lakewood, NJ
  • NPI 1124603246

  IL

  Medicare reassignment NPD

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1184045031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "767 30TH STREET",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "61201",
            "telephone_number": "309-788-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 30TH STREET",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "61201",
            "telephone_number": "309-788-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JACOB",
        "middle_name": "MATTHEW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-19",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anchor Home Care, Inc
• Alyssa K. Anderson, O.D.
• Angela Marie Anderson
• Darcy Jean Anderson, PA-C
• Evelyn Ann Anderson
• Jeramie Anderson
• Karen Jean Anderson
• Tina Ann Anderson
• Diana Theodora Anghel
• Irfan Muniruddin Ankolkar, MD

• Physical Therapist in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.