Jacob Long, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

14-02892 Issued in KS

Practice address

5220 SW 17TH St Ste 130
Topeka, KS 66604-2514

Phone

(785) 271-5533

Fax

(785) 271-8818

NPI assigned

Jan 14, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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 and National Provider Directory roles.

• Rebound Physical Therapy Inc.

  • Physical Therapist
  • Topeka, KS
  • NPI 1003810466
  NPD
• Rebound Physical Therapy at Wood Valley

  • Physical Therapist
  • Topeka, KS
  • NPI 1891711974
  NPD (past)

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1326637240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 SW 17TH ST STE 130",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666042514",
            "telephone_number": "785-271-5533",
            "fax_number": "785-271-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 SW 17TH ST STE 130",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666042514",
            "telephone_number": "785-271-5533",
            "fax_number": "785-271-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JACOB",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KS",
            "license": "14-02892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constance Ann Lofgreen, MSW LSCSW
• Robert R Lohse Jr., D.D.S.
• Nancy Nadine Lollman, LSCSW
• Charity Long
• Diane Marie Long
• Melinda Joliene Long, REGISTERED NURSE
• Michael Ray Longhofer, ATC
• Peter L Loo, MD
• Paige A Lopeman, TLMLP
• Jose A Lopez-Reyes, D.M.D.

• Physical Therapy Assistant in Topeka, KS
• Providers in Topeka, KS by specialty
• Physical Therapy Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.