Kimberly Ann Jacob, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1389 Issued in AZ

Practice address

118 E Waltann LN
Phoenix, AZ 85022-3037

Phone

(602) 692-7232

NPI assigned

Aug 23, 2010

Last updated

Aug 23, 2010By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

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

• Arizona Mobile Therapy LLC

  • Physical Therapist
  • Surprise, AZ
  • NPI 1104521616
  Medicare reassignment NPD

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1669788139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 E WALTANN LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850223037",
            "telephone_number": "602-692-7232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E WALTANN LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850223037",
            "telephone_number": "602-692-7232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "1389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "356388",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacksons Youth and Family Service
• Jacob Hanson DC Inc
• Jacob Transportation Inc
• Annie Jacob, DNP
• Jessica Jacob
• Stephanie Jacob
• Deborah Ann Jacobi, PNP
• Jaclyn Elyse Jacobi, MD
• Jeanette Jacobo Sanchez
• Marylou Jacobo, CNA

• Physical Therapist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; 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.