Active NPI
Jacob David Spring, DPT
- Orthopedic Physical Therapist
- Shallotte, NC
National Provider Identifier
1669296836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- P23894
- Practice address
- 5160 Ocean Hwy W
Shallotte, NC 28470-4012 - Phone
- (910) 332-3828
- NPI assigned
- Nov 13, 2024
- Last updated
- Mar 4, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 049146 | NY | |
| Orthopedic Physical Therapist | 2251X0800X | P23894 | NC | Primary |
Addresses
Primary practice location
5160 Ocean Hwy W
Shallotte, NC 28470-4012
Mailing address
290 Landings Dr
Buffalo, NY 14228-3710
Phone (716) 908-8693
Other practice location 1
918 Ulster Ave
Kingston, NY 12401-1372
Phone (845) 802-7080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241121003788 | NY | Practitioner - Physical Therapist in Private Practice | 5092240499 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P23894 | NC | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741046400000",
"number": "1669296836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 LANDINGS DR",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142283710",
"telephone_number": "716-908-8693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5160 OCEAN HWY W",
"city": "SHALLOTTE",
"state": "NC",
"postal_code": "284704012",
"telephone_number": "910-332-3828"
}
],
"practiceLocations": [
{
"address_1": "918 Ulster Ave",
"address_purpose": "LOCATION",
"city": "Kingston",
"state": "NY",
"postal_code": "124011372",
"country_code": "US",
"telephone_number": "845-802-7080",
"fax_number": "845-663-1351",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SPRING",
"first_name": "JACOB",
"middle_name": "DAVID",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-13",
"last_updated": "2025-03-04",
"certification_date": "2025-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "049146",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NC",
"license": "P23894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shallotte, NC
- Lydia Michl Sommer, P018308
- Southeastern Healthcare Centers PC
- Southeastern United Care LLC
- Jenna Leander Spell, PHARMD
- Sarah Spell, LCSWA, LCASA
- Zachery Taylor Stephenson, O.D.
- Stoldaddy Inc. (Lundy Chiropractic and Rehab)
- Heather Shannon Stoume Stoume, MSW, LCSW, LCAS,
- Jenna Strickland, PT
- Carmen Michelle Suedmeier, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.