LISA M JACKOWIAK (PT) – Physical Therapist, NPI 1720301039

LISA M JACKOWIAK (PT) is a healthcare provider. based in Jasper, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT016702 (GA). The NPI Number for LISA M JACKOWIAK (PT) is 1720301039

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
LISA M JACKOWIAK (PT)
NPI
1720301039
Phone
(706) 692-9080
Address
620 J L WHITE DR STE 110
Enumeration Date
2 March 2010
Last Update Date
1 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7062536287
Graduation Year
2009 (17 years ago)
PAC ID
3779609755
Group Practice PAC ID
8123065406
Professional Enrollment ID
I20230830003548
Address ID
GA301438707JA371XXDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:16State licenses:2Digital endpointsOther names

2,871 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

Provider Addresses for LISA M JACKOWIAK (PT)

  • 620 J L WHITE DR STE 110

    JASPER, GA 301434897

    Phone: (706) 692-9080

    Fax: (706) 692-1199

    Type: Location

  • PO BOX 949

    ROME, GA 301620949

    Phone: (706) 692-9080

    Fax: (706) 692-1199

    Type: Mailing

  • 348, Long Rapids Plaza, Alpena, Alpena County, Michigan, 49707, United States

    ALPENA, MI 497071374

    Phone: (989) 358-8086

    Fax: (989) 354-2253

    Type: Mailing

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: 2023-08-30

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
I20230830003548IPhysical Therapist In Private PracticeGATBD

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 minutes1,09771$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care21136$0
97150Therapy procedure in a group setting21050$0
97140Therapy procedure using manual technique, each 15 minutes19733$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes15233$0
View full utilization report →

Insurance plans in this area (ZIP 30143)

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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: 8123065406View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Qualified Speech Language PathologistGA
Qualified Speech Language PathologistGA

Reviews

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Frequently asked questions

What is the registry number for LISA M JACKOWIAK (PT)?
The registry entry for LISA M JACKOWIAK (PT) shows NPI 1720301039.
Should I treat LISA M JACKOWIAK (PT) as an active provider?
Patients and plans typically see LISA M JACKOWIAK (PT) as active in the national extract.
What type of care does LISA M JACKOWIAK (PT) provide?
LISA M JACKOWIAK (PT)'s profile centers on Physical Therapist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to LISA M JACKOWIAK (PT)?
LISA M JACKOWIAK (PT) is associated with Jasper, Georgia in the same public data insurers reference.
Who maintains LISA M JACKOWIAK (PT)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.