Individual provider Active NPI

Jacob Torre Myers

  • Physical Therapist
  • Columbia, MD
National Provider Identifier
1871223776
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
8895 McGaw Rd Ste G
Columbia, MD 21045-4746
Phone
(443) 441-0616
NPI assigned
Jun 14, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

8895 McGaw Rd Ste G
Columbia, MD 21045-4746

Mailing address

125 W Randall St
Baltimore, MD 21230-4445
Phone (443) 974-5388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220627001112 MD Practitioner - Physical Therapist in Private Practice 0547649295 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Felice Physical Therapy Physical Therapist CurrentSince Jun 28, 2022 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 7, 2023 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 7, 2023 Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

10 Light St
Baltimore, MD 21202
Phone (410) 202-8581

8895 McGaw Rd
Ste G
Columbia, MD 21045
Phone (443) 441-0616

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1871223776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 W RANDALL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212304445",
            "telephone_number": "443-974-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8895 MCGAW RD STE G",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454746",
            "telephone_number": "443-441-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JACOB",
        "middle_name": "TORRE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.