BRADEN GAGE JACKSON – Physical Therapist, NPI 1124830419

BRADEN GAGE JACKSON is a healthcare provider. based in Hoover, Alabama. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 009273 (KY). The NPI Number for BRADEN GAGE JACKSON is 1124830419

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
BRADEN GAGE JACKSON
NPI
1124830419
Phone
(423) 238-7217
Address
1200 CORPORATE DR STE 400
Enumeration Date
23 January 2025
Last Update Date
5 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8593000440
Graduation Year
2024 (2 years ago)
PAC ID
8729508031
Group Practice PAC ID
0042577579
Professional Enrollment ID
I20250217002610
Address ID
KY405092229LE2160XWAYX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

1,255 PHYSICAL THERAPIST IN PRIVATE PRACTICE in KY

Provider Addresses for BRADEN GAGE JACKSON

  • 1200 CORPORATE DR STE 400

    HOOVER, AL 352425424

    Phone: (423) 238-7217

    Type: Mailing

  • 1010 MONARCH ST STE 150

    LEXINGTON, KY 405131892

    Phone: (859) 219-0211

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-02-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250217002610IPhysical Therapist In Private PracticeKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35242)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042577579View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeIN
-KY
Physical Therapist In Private PracticeAL
-KY
Physical Therapist In Private PracticeTN
-AL
Physical Therapist In Private PracticeKY

Reviews

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Frequently asked questions

Where can patients find BRADEN GAGE JACKSON's NPI?
You can confirm BRADEN GAGE JACKSON with NPI 1124830419; it appears in the national provider directory.
Is BRADEN GAGE JACKSON active in the national directory?
BRADEN GAGE JACKSON's public NPI profile is in an active state.
What kind of provider is BRADEN GAGE JACKSON?
The page reflects Physical Therapist for BRADEN GAGE JACKSON. Clinical services aligned with this taxonomy classification.
Where does public data place BRADEN GAGE JACKSON?
The snapshot lists Hoover, Alabama for BRADEN GAGE JACKSON; download NPPES for the complete set.
How can I contact BRADEN GAGE JACKSON?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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