Individual provider Active NPI

Jacob Burton, DPT

  • Physical Therapist
  • Columbia, MO
National Provider Identifier
1396482576
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2022013714 Issued in MO
Practice address
2003 W Broadway Ste 105
Columbia, MO 65203-1136
Phone
(573) 474-5111
NPI assigned
May 18, 2022
Last updated
May 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2022013714 MO Primary

Addresses

Primary practice location

2003 W Broadway Ste 105
Columbia, MO 65203-1136

Mailing address

3601 W Broadway Apt 11101
Columbia, MO 65203-7912
Phone (913) 208-2240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220701000676 MO Practitioner - Physical Therapist in Private Practice 6507246907 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Missouri Physical Therapy LLC Physical Therapist CurrentSince May 31, 2022 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Theraphysics Partners of Colorado Inc Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Theraphysics Partners of Colorado, Inc. Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Boone Physician Services, LLC PastSince May 22, 2022 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Select Physical Therapy of Denver LTD Physical Therapist Past Accepting new patients

Locations

2003 W Broadway
Ste 105
Columbia, MO 65203
Phone (573) 474-5111

3301 Berrywood Dr
Ste 204
Columbia, MO 65201
Phone (573) 374-7579

Organizations & group practices 11

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": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1396482576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W BROADWAY APT 11101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652037912",
            "telephone_number": "913-208-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 W BROADWAY STE 105",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652031136",
            "telephone_number": "573-474-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTON",
        "first_name": "JACOB",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2022013714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.