Jacob Wright, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10249 Issued in TN

Practice address

110 E Center St
Kingsport, TN 37660-4230

Phone

(423) 765-1611

Fax

(423) 765-1612

NPI assigned

Sep 10, 2014

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Achieve Health and Wellness

  • Physical Therapy Clinic/Center
  • Gray, TN
  • NPI 1386914158
  NPD (past)

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1487055463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 ROY MARTIN RD STE 9",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376152245",
            "telephone_number": "423-477-1101",
            "fax_number": "423-477-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E CENTER ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604230",
            "telephone_number": "423-765-1611",
            "fax_number": "423-765-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-10",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "10249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q010967",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTN",
            "identifier": "6025087",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda L Wright-Brown, DNP,FNP-C
• Alicia Wright, MD
• Derek Taylor Wright
• Douglas A Wright, M.D.
• George William Wright, CRNA
• Jennifer R Wright, ANP
• Arthur T Wyker, M.D.
• Stephen Yallourakis, MD
• Sara Yarber
• Peter Matthew Yarger, MD

• All providers in Kingsport, TN
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.