Jacob Henry Jaffe, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P21096 Issued in NC

Practice address

2000 Brabham Ave Ste 100
Jacksonville, NC 28546-0202

Phone

(910) 332-3800

NPI assigned

Nov 6, 2019

Last updated

Mar 10, 2022By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Emergeortho PA

  • Orthopaedic Surgery Physician
  • Durham, NC
  • NPI 1376592964

  Physical Therapist

  NPD
• Emergeortho PA

  • Durable Medical Equipment & Medical Supplies
  • Eden, NC
  • NPI 1841170222
  NPD
• Physicians Physical Therapy Service, Inc.

  dba Wilshire-Linden Physical Therapy

  • Physical Therapy Clinic/Center
  • Los Angeles, CA
  • NPI 1225190473

  Physical Therapist

  NPD
• Emergeortho, PA

  • Orthopaedic Surgery Physician
  • Jacksonville, NC
  • NPI 1598111957
  NPD (past)

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1932743515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10474 SANTA MONICA BLVD STE 435",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256932",
            "telephone_number": "310-275-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 BRABHAM AVE STE 100",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285460202",
            "telephone_number": "910-332-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10474 Santa Monica Blvd Ste 435",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900256932",
            "country_code": "US",
            "telephone_number": "310-275-4137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAFFE",
        "first_name": "JACOB",
        "middle_name": "HENRY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-06",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297641",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacksonville Treatment Center
• Jacksonville Vision Center, O.D.,PLLC
• Catherine Veronica Jacobs
• Heather Nicole Jacoby
• Paul Jacome Sanchez
• Melvin Wade James II, APRN
• Jan's Angels LLC
• Stefanie Jarrett, MOT, OTR/L
• Jarrod L. Gray, LPC, PC
• Nagesh H Jayaram, MD

• Physical Therapist in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.