Active NPI
Laura Jacobs
- Physical Therapist
- Leonardtown, MD
National Provider Identifier
1992658488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 30758
- Practice address
- 23000 Moakley St Ste 101
Leonardtown, MD 20650-2916 - Phone
- (301) 475-5830
- NPI assigned
- Feb 16, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 30758 | MD | Primary |
Addresses
Primary practice location
23000 Moakley St Ste 101
Leonardtown, MD 20650-2916
Mailing address
21395 Fairwood CT
Leonardtown, MD 20650-6128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30758 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1771200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771200000000",
"number": "1992658488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21395 FAIRWOOD CT",
"city": "LEONARDTOWN",
"state": "MD",
"postal_code": "206506128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23000 MOAKLEY ST STE 101",
"city": "LEONARDTOWN",
"state": "MD",
"postal_code": "206502916",
"telephone_number": "301-475-5830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "LAURA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-02-16",
"last_updated": "2026-02-16",
"certification_date": "2026-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "30758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leonardtown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.