Kendra Jacob, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-2024-0186 Issued in NM

Practice address

2404 S Locust St Ste 5
Las Cruces, NM 88001-5789

Phone

(575) 521-4188

NPI assigned

Sep 9, 2024

Last updated

Sep 9, 2024By the provider in NPPES

Sex

Female

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 NM

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Mexico Orthopaedic Associates PCGroup PAC ID 1759270713, 74 clinicians

Southwest Sport and Spine Center IncGroup PAC ID 5496656563, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• New Mexico Orthopaedic Associates PC

  • Orthopaedic Surgery Physician
  • Albuquerque, NM
  • NPI 1407898299
  Medicare reassignment Care Compare group NPD
• Southwest Sport and Spine Center Inc

  • Physical Therapist
  • Las Cruces, NM
  • NPI 1164475208
  Medicare reassignment Care Compare group NPD
• New Mexico Orthopaedic Associates PC

  • Durable Medical Equipment & Medical Supplies
  • Albuquerque, NM
  • NPI 1942236971

  Physical Therapist

  NPD
• Real View Diagnostics LLC

  • Physical Therapist
  • Canutillo, TX
  • NPI 1336882026
  NPD (past)

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1952136988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 S LOCUST ST STE 5",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880015789",
            "telephone_number": "575-640-7594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 S LOCUST ST STE 5",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880015789",
            "telephone_number": "575-521-4188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1181 Mall Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880118105",
            "country_code": "US",
            "telephone_number": "575-522-0766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "KENDRA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "PT-2024-0186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Menalyn Balancio Jabonete, PT/L
• Ernest Rhett Jabour
• Cisco Jackson
• Jessica Jackson
• Zachary Bradley Jackson, DPT
• Kent F Jacobs, MD
• Jacqueline Villalobos ND LLC
• Albert L Jacquez, LMSW
• Mandy Marie Jacquez, LCSW
• Tracey A Jaglowitz, PHARMD, RPH, PHC, MS

• Physical Therapist in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Physical Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.