Jacob Jackson

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

838 Powdersville Rd Ste T
Easley, SC 29642-3703

Phone

(864) 671-1650

NPI assigned

Feb 20, 2024

Last updated

Jul 10, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, DC, MD, SC, NM5 enrollments

Enrollment records 5

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physical Therapy at Dawn LLCGroup PAC ID 0042221889, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Physical Therapy at Dawn, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Albuquerque, NM
  • NPI 1780695551
  Medicare reassignment Care Compare group NPD
• Drayer Physical Therapy-South Carolina, LLC

  • Physical Therapist
  • Columbia, SC
  • NPI 1841622354
  Medicare reassignment NPD
• Greenville Proaxis Therapy, LLC

  dba ATI Physical Therapy of Greenville

  • Physical Therapist
  • Greenville, SC
  • NPI 1669457859
  Medicare reassignment NPD
• Advanced Physical Therapy, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Indianapolis, IN
  • NPI 1316940505
  Medicare reassignment NPD
• Agilitas USA Inc

  dba Results Physiotherapy

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  Physical Therapist, SC

  Medicare reassignment NPD
• Ati Holdings, LLC

  dba ATI Physical Therapy

  • Physical Therapy Clinic/Center
  • Rising Sun, MD
  • NPI 1396781050

  DC, Physical Therapist

  Medicare reassignment NPD
• Benchmark Healthcare Services, LLC

  • Physical Therapist
  • Ooltewah, TN
  • NPI 1811213341

  SC

  Medicare reassignment NPD
• Benchmark Health Services

  • Physical Therapist
  • Easley, SC
  • NPI 1457842643
  NPD
• Drayer Physical Therapy - South Carolina, LLC

  • Physical Therapist
  • Camden, SC
  • NPI 1154816833
  NPD
• Greenville Proaxis Therapy LLC

  dba ATI Physical Therapy

  • Durable Medical Equipment & Medical Supplies
  • Greenville, SC
  • NPI 1740052000
  NPD
• Advanced Physical Therapy, LLC

  • Durable Medical Equipment & Medical Supplies
  • Indianapolis, IN
  • NPI 1700595089

  Physical Therapist

  NPD
• Agilitas USA, Inc

  dba Results Physiotherapy

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1902661838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 POWDERSVILLE RD STE T",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423703",
            "telephone_number": "864-671-1650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6842 Race Track Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Bowie",
            "state": "MD",
            "postal_code": "207153011",
            "country_code": "US",
            "telephone_number": "240-544-0200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1312 W Arch Haven Ave Ste E",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032088",
            "country_code": "US",
            "telephone_number": "812-336-8406",
            "fax_number": "812-336-8342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-20",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT43269",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Oliver Ivey Jr., RPH
• J.N. St John LLC (St John Family Chiropractic Clinic)
• Lyle Hendricks Jacks, LMSW
• Davis Christopher Jackson, PT, DPT
• Emalie Jackson, OTRL
• Vanessa Louise Jackson, OTR
• David Calhoun Jacobs Jr., MD
• Vikas Raja Jain, DMD
• James J. Lynn, DMD, PA
• Andrea Shavonne James, MD

• Physical Therapist in Easley, SC
• Providers in Easley, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.