Jacob McCrowell, DPT, CMTPT
Individual provider Active NPI Physical Therapist · VA Beach, VA
NPI 1669876017 · NPPES record last updated Oct 6, 2021
Key facts
- NPI
- 1669876017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2305206470 (VA)
- Practice address
- 4554 Virginia Beach Blvd Ste 970
VA Beach, VA 23462-3047 - Phone
- (757) 742-3778
- NPI assigned
- Oct 14, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150311000931 | VA | Practitioner - Physical Therapist in Private Practice | 9436475340 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Direct Performance Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
| DPPT 2, LLC | Physical Therapist | Past |
Accepting new patients |
Locations
4554 Virginia Beach Blvd
Ste 970
Virginia Beach, VA 23462
Phone (757) 636-6727
2247 W Great Neck Rd
Ste 101
Virginia Beach, VA 23451
Phone (757) 589-7585
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305206470 | VA | Yes |
Addresses
Primary practice location
4554 Virginia Beach Blvd Ste 970
VA Beach, VA 23462-3047
Mailing address
2247 W Great Neck Rd Ste 101
VA Beach, VA 23451-1556
Phone (757) 742-3787
Other providers in VA Beach, VA
- Jennifer J Martin
- Kimberly Duncan Martinez
- Mawussi Komi
- Karen McCleu-Jackson
- Natalie McCorey
- Charles Scott McEnroe
- Laura Speas McFarland
- Megan K Mikovits
- Jennifer U Miles-Thomas
- Sharita Miller
All providers in VA Beach, VA · Physical Therapist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2021. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.