Trevor James Jacob, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05015093A Issued in IN

Practice address

10767 Illinois St Ste 3000
Carmel, IN 46032-8972

Phone

(317) 817-1200

Fax

(317) 817-1220

NPI assigned

May 16, 2023

Last updated

May 23, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thomas a Brady Sports Medicine Center, PC

  dba Forte Sports Medicine and Orthopedics

  • Orthopaedic Surgery Physician
  • Noblesville, IN
  • NPI 1407480239

  Physical Therapist

  NPD
• Thomas a Brady Sports Medicine Center, PC

  dba Forte Sports Medicine and Orthopedics

  • Orthopaedic Surgery Physician
  • Carmel, IN
  • NPI 1467484212

  Physical Therapist

  NPD

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1386335917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10767 ILLINOIS ST STE 3000",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328972",
            "telephone_number": "317-817-1200",
            "fax_number": "317-817-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10767 ILLINOIS ST STE 3000",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328972",
            "telephone_number": "317-817-1200",
            "fax_number": "317-817-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "TREVOR",
        "middle_name": "JAMES",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "8692",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05015093A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenda Jackson Prabu
• Erin Colleen Jackson
• Michelle N Jackson, SPEECH PATHOLOGIST
• Valerie Kaye Jackson, NP
• Dennis M Jacob, M.D.
• Lisbeth Jacobs
• Stephen Peter Jacobsen, MD
• Loren K Jacobus, NP
• Barbara B Jager, PT
• Patty Jager, PTA

• Physical Therapist in Carmel, IN
• Providers in Carmel, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.