Individual provider Active NPI

Jacob Stratton, PT, DPT

  • Physical Therapist
  • San Antonio, TX
National Provider Identifier
1912365511
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1270661 Issued in TX
Practice address
288 W Bitters Rd
San Antonio, TX 78216-1665
Phone
(210) 297-9906
NPI assigned
Feb 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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 1270661 TX Primary

Addresses

Primary practice location

288 W Bitters Rd
San Antonio, TX 78216-1665

Mailing address

PO Box 70689
Salt Lake City, UT 84170-0689
Phone (801) 987-8600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201118002292 UT Practitioner - Physical Therapist in Private Practice 9234540402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Land Rehabilitation LLCGroup PAC ID 9234048745, 207 clinicians

Practice addresses (Care Compare)

1950 E Fort Union Blvd
Suite 2
Salt Lake City, UT 84121-6894
Phone (801) 943-1041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1270661TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Land Rehabilitation LLC Physical Therapist CurrentSince Apr 14, 2022 Accepting new patients

Locations

4587 W Cedar Hills Dr
Ste 110
Cedar Hills, UT 84062
Phone (801) 406-6943

5872 S 900 E
Ste 150
Murray, UT 84121
Phone (801) 265-0600

1950 E Fort Union Blvd
Ste 2
Salt Lake City, UT 84121
Phone (801) 943-1041

4179 S Riverboat Rd
Ste 110
Taylorsville, UT 84123
Phone (801) 337-4475

Organizations & group practices 1

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": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1912365511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70689",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841700689",
            "telephone_number": "801-987-8600",
            "fax_number": "801-987-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 W BITTERS RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782161665",
            "telephone_number": "210-297-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRATTON",
        "first_name": "JACOB",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-10",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1270661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.