Individual provider Active NPI

Shana Jacob

  • Physical Therapist
  • Thornton, CO
National Provider Identifier
1376264739
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
9351 Grant St Ste 430
Thornton, CO 80229-4365
Phone
(303) 280-1211
NPI assigned
Sep 6, 2022
Last updated
Aug 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL.0021425 CO
Physical Therapist 225100000X Primary
Physical Therapist 225100000X LPT-034506 AZ

Addresses

Primary practice location

9351 Grant St Ste 430
Thornton, CO 80229-4365

Mailing address

9351 Grant St Ste 430
Thornton, CO 80229-4365

Other practice location 1

890 N Green St Ste A
Brownsburg, IN 46112-1031
Phone (317) 520-5479

Other practice location 2

2401 Ravine Way Ste 100
Glenview, IL 60025-7645
Phone (847) 724-4791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN, CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20221213001129 IL Practitioner - Physical Therapist in Private Practice 1850760976
I20251021002360 IN Practitioner - Physical Therapist in Private Practice 1850760976 Reassigns benefits to 1 organization
I20260604004764 CA Practitioner - Physical Therapist in Private Practice 1850760976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
More Physical Therapy IncGroup PAC ID 5294783122, 51 clinicians
Advanced Physical Therapy LLCGroup PAC ID 6002959525, 170 clinicians

Practice addresses (Care Compare)

1530 Meridian Ave
Suite 150
San Jose, CA 95125-5352
Phone (408) 606-7951

890 N Green St
Suite a
Brownsburg, IN 46112-1031
Phone (317) 520-5479

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-034506AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Sep 22, 2025 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Sep 22, 2025 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

890 N Green St
#A
Brownsburg, IN 46112
Phone (317) 520-5479

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

Organizations & group practices 5

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": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1376264739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9351 GRANT ST STE 430",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9351 GRANT ST STE 430",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294365",
            "telephone_number": "303-280-1211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "890 N Green St Ste A",
            "address_purpose": "LOCATION",
            "city": "Brownsburg",
            "state": "IN",
            "postal_code": "461121031",
            "country_code": "US",
            "telephone_number": "317-520-5479",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2401 Ravine Way Ste 100",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600257645",
            "country_code": "US",
            "telephone_number": "847-724-4791",
            "fax_number": "847-998-6916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SHANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-06",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0021425",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-034506",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.