Katherine Ann Jacob, PT, DPT
Individual provider Active NPI Physical Therapist · Loveland, CO
NPI 1659968337 · NPPES record last updated Jul 9, 2023
Key facts
- NPI
- 1659968337
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PTL.0019174 (CO)
- Practice address
- 730 14TH St SW Unit 200
Loveland, CO 80537-6349 - Phone
- (970) 663-0815
- NPI assigned
- Dec 28, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Back in Action Physical Therapy LLC
Practice addresses (Care Compare)
1001 E Bogard Rd
Wasilla, AK 99654-7114
Phone (907) 373-7246
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD, AK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210927000204 | MD | Practitioner - Physical Therapist in Private Practice | 2860899325 | Reassigns benefits to 2 organizations |
| I20250310001292 | AK | Practitioner - Physical Therapist in Private Practice | 2860899325 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ati Holdings, LLC | Physical Therapist | Current |
Accepting new patients |
| Ati Holdings, LLC | Physical Therapist | Current |
Accepting new patients |
| Back 2 You Speech Language Pathology, PLLC | Physical Therapist | Past |
Accepting new patients |
| Orchard Park Progressive Physical Therapy PLLC | Physical Therapist | Past |
Accepting new patients |
Locations
790 Remington Blvd
Bolingbrook, IL 60440
4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001
1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619
52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100
1409 S Salisbury Blvd
Unit Cd
Salisbury, MD 21801
Phone (667) 330-1061
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 046818 | NY | |
| Physical Therapist | 225100000X | PTL.0019174 | CO | Yes |
Addresses
Primary practice location
730 14TH St SW Unit 200
Loveland, CO 80537-6349
Mailing address
730 14TH St SW Unit 200
Loveland, CO 80537-6349
Phone (970) 663-0815
Other names
- Katherine Ann Jacob
Other providers in Loveland, CO
- It'S Me Again of Colorado, Inc
- Heather Jackson
- Madelyn Jackson
- Michelle Laporte Jackson
- Joseph P Jacob
- Prema M Jacob
- Kathleen M Jacober
- Erin Jacobs
- Melinda Jacquez
- James K Richards DDS PC
All providers in Loveland, CO · Physical Therapist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.