Jacob Daniel Edwards, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1387327 Issued in TX

Practice address

8910 Bandera Rd Ste 112
San Antonio, TX 78250-3227

Phone

(210) 318-3979

Fax

(210) 503-9662

NPI assigned

Jan 17, 2024

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 TX

Enrollment records 1

Medicare enrollment (NPD)

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.

• Ideal Physical Therapy of Texas LLC

  • Physical Therapist
  • Plano, TX
  • NPI 1538573746
  Medicare reassignment NPD
• Ideal Physical Therapy of Texas LLC

  • Durable Medical Equipment & Medical Supplies
  • Murphy, TX
  • NPI 1902773161
  NPD

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1336900489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8910 BANDERA RD STE 112",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782503227",
            "telephone_number": "210-318-3979",
            "fax_number": "210-503-9662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17026 Bulverde Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782474700",
            "country_code": "US",
            "telephone_number": "210-819-2994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1123 N Main Ave Ste 211",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782124738",
            "country_code": "US",
            "telephone_number": "210-226-2101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JACOB",
        "middle_name": "DANIEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1387327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evie Marie Edwards, LPC-ASSOCIATE
• Frida Edwards
• Gina Edwards, LVN
• Hannah Edwards, SLP-ASSISTANT
• Ivan Edwards, D.O.
• Jessica P. Edwards, M.D.
• Joe C Edwards, DDS
• Kaelyn Grace Edwards
• Kaitlyn Edwards
• Katherine Anne Edwards, MD

• Physical Therapist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.