Jonathan Casey Jacobsen, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6240 Issued in NV

Practice address

611 Mall Ring Cir
Henderson, NV 89014-6619

Phone

(702) 483-5900

NPI assigned

Aug 21, 2023

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1952185159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 WIGWAM PKWY APT 722",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746234",
            "telephone_number": "972-821-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 MALL RING CIR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890146619",
            "telephone_number": "702-483-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3165 N Rainbow Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891084578",
            "country_code": "US",
            "telephone_number": "702-463-6555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "JONATHAN",
        "middle_name": "CASEY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "6240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Jacobs, PSY.D.
• Leslie Jacobs, M.D.
• Loring Jacobs, M.D.
• Rachel Jacobs
• Trina Jacobs
• Briar Rose Jacobson, MA
• Scott Neil Jacobson, MD
• Kristina Jacome
• Yutoshica Jacques
• Adella Jenny Jaeger, LCSW

• Physical Therapist in Henderson, NV
• Providers in Henderson, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.