JESSICA D MATHIS (PT, DPT) – Physical Therapist, NPI 1639659972

JESSICA D MATHIS (PT, DPT) is a healthcare provider. based in Fayetteville, Arkansas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 4425 (AR). The NPI Number for JESSICA D MATHIS (PT, DPT) is 1639659972

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA D MATHIS (PT, DPT)
NPI
1639659972
Phone
(479) 713-8630
Address
1125 N COLLEGE AVE
Enumeration Date
16 August 2018
Last Update Date
16 August 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4796218008
Graduation Year
2011 (15 years ago)
PAC ID
5193078418
Group Practice PAC ID
8628401957
Professional Enrollment ID
I20181102000092
Address ID
AR727588231RO3612XBLVD502
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

835 PHYSICAL THERAPIST IN PRIVATE PRACTICE in AR

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Provider Addresses for JESSICA D MATHIS (PT, DPT)

  • UAMS Northwest, 1125, North College Avenue, Evelyn Hills Shopping Center, Fayetteville, Washington County, Arkansas, 72703, United States

    FAYETTEVILLE, AR 727031908

    Phone: (479) 713-8630

    Fax: (479) 713-5150

    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: 2018-11-02

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
I20181102000092IPhysical 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.

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

Insurance plans in this area (ZIP 72703)

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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: 8628401957View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeAR
Physical Therapist In Private PracticeFL
Physical Medicine And RehabilitationAR

Reviews

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Frequently asked questions

What number should I use to identify JESSICA D MATHIS (PT, DPT) for billing?
Administrative and clinical systems typically use NPI 1639659972 for JESSICA D MATHIS (PT, DPT).
Is JESSICA D MATHIS (PT, DPT)'s NPI status active today?
Active status means JESSICA D MATHIS (PT, DPT)'s NPI record is not deactivated in the public file.
Which specialty label fits JESSICA D MATHIS (PT, DPT)?
NPPES ties JESSICA D MATHIS (PT, DPT) to Physical Therapist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to JESSICA D MATHIS (PT, DPT)?
JESSICA D MATHIS (PT, DPT) is associated with Fayetteville, Arkansas in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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