Jacob Collins Brister, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1226956 Issued in TX

Practice address

4601 Hartford St
Abilene, TX 79605-4603

Phone

(325) 793-3411

NPI assigned

Feb 10, 2013

Last updated

Feb 10, 2013By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Dynamic Therapy Solutions, LLC

  • Physical Therapist
  • Monroe, LA
  • NPI 1265064760
  Medicare reassignment NPD
• Jackson Parish Therapy Center LLC

  dba Fyzical Therapy & Balance Centers

  • Physical Therapist
  • Ruston, LA
  • NPI 1891794491
  NPD (past)

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

{
    "created_epoch": "1360454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360454400000",
    "number": "1922347079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 HARTFORD ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796054603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 HARTFORD ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796054603",
            "telephone_number": "325-793-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTER",
        "first_name": "JACOB",
        "middle_name": "COLLINS",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-10",
        "last_updated": "2013-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1226956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Alan Bridge, M.D.
• Brightshield Technologies LLC (BrightShield Integrated Services)
• Kamryn Jade Briley
• Robert A Brimmer II, M.D.
• Samuel D Brinkman, PH.D.
• Jeremy Blaine Britten, M.D.
• Sarah Jordan Brock, M.S. CCC-SLP
• Brookhollow Senior Living LLC (Wisteria Place Assisted Living)
• Brooks T. Grant, O.D., PLLC
• Bethany Brooks, LMSW

• Physical Therapist in Abilene, TX
• Providers in Abilene, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2013; 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.