MR. JACOB DARRELL JOHNSON (DPT) – Physical Therapist, NPI 1174873723

MR. JACOB DARRELL JOHNSON (DPT) is a healthcare provider. based in Lonoke, Arkansas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PT 3506 (AR). The NPI Number for MR. JACOB DARRELL JOHNSON (DPT) is 1174873723

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
MR. JACOB DARRELL JOHNSON (DPT)
NPI
1174873723
Phone
(501) 676-5540
Address
1515 NORTH CENTER STREET
Enumeration Date
11 September 2012
Last Update Date
11 September 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5012866059
Graduation Year
2012 (14 years ago)
PAC ID
7214187657
Group Practice PAC ID
2062715444
Professional Enrollment ID
I20121022000260
Address ID
AR720238606CA100XXDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

838 PHYSICAL THERAPIST IN PRIVATE PRACTICE in AR

Provider Addresses for MR. JACOB DARRELL JOHNSON (DPT)

  • 1515 NORTH CENTER STREET

    SUITE 5

    LONOKE, AR 72086

    Phone: (501) 676-5540

    Fax: (501) 676-6499

    Mailing address matches the actual address.

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: 2012-10-22

PECOS data refreshed: 2026-06-15

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
I20121022000260IPhysical Therapist In Private PracticeARTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes39720$0
97161Evaluation for physical therapy, typically 20 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 72086)

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Provider's Procedures

MR. JACOB DARRELL JOHNSON (DPT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYAR97001Physical therapy evaluation7370
PHYSICAL THERAPYAR97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes37348

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: 2062715444View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeAR
-AR
Physical Therapist In Private PracticeAR
Physical Therapist In Private PracticeAR
Physical Therapist In Private PracticeAR

Reviews

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Frequently asked questions

How do payers reference MR. JACOB DARRELL JOHNSON (DPT)?
For MR. JACOB DARRELL JOHNSON (DPT), use NPI 1174873723 as the unique 10-digit identifier.
Would MR. JACOB DARRELL JOHNSON (DPT) appear as active to a payer?
You can treat MR. JACOB DARRELL JOHNSON (DPT) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is MR. JACOB DARRELL JOHNSON (DPT)?
MR. JACOB DARRELL JOHNSON (DPT) is associated with Physical Therapist in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with MR. JACOB DARRELL JOHNSON (DPT)?
Directory geography for MR. JACOB DARRELL JOHNSON (DPT) centers on Lonoke, Arkansas.
When was this NPI issued?
Enumeration for MR. JACOB DARRELL JOHNSON (DPT) is noted as September 11, 2012 where the registry provides it.

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