MR. JACOB RYAN DAVIS (MS, OTR/L) – Occupational Therapist, NPI 1417428350

MR. JACOB RYAN DAVIS (MS, OTR/L) is a healthcare provider. based in Georgetown, Kentucky. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials MS, OTR/L. They hold a License No. 244835 (KY). The NPI Number for MR. JACOB RYAN DAVIS (MS, OTR/L) is 1417428350

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
MR. JACOB RYAN DAVIS (MS, OTR/L)
NPI
1417428350
Phone
(502) 863-3696
Address
102 Pocahontas Trl
Enumeration Date
17 December 2018
Last Update Date
26 November 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8596256986
Graduation Year
2018 (8 years ago)
PAC ID
6608200639
Group Practice PAC ID
4082934070
Professional Enrollment ID
I20191230001236
Address ID
KY404752998RI350XXDRXX401
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

297 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in KY

Provider Addresses for MR. JACOB RYAN DAVIS (MS, OTR/L)

  • 102 Pocahontas Trl

    Georgetown, KY 403241123

    Phone: (502) 863-3696

    Type: Location

  • Radio Park Drive, Richmond, Madison County, Kentucky, 40475, United States

    RICHMOND, KY 404752998

    Phone: (937) 478-2350

    Fax: (859) 625-5987

    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: 2019-12-30

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
I20191230001236IOccupational 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.

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 minutes40743$0
97140Therapy procedure using manual technique, each 15 minutes32239$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes15822$0
97530Therapy procedure using functional activities11722$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care8611$0
View full utilization report →

Insurance plans in this area (ZIP 40324)

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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: 4082934070View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeKY
-KY
Physical Therapist In Private PracticeKY
Physical Therapist In Private PracticeKY
Occupational Therapist In Private PracticeKY
-KY
Physical Therapist In Private PracticeKY
-KY
Physical Therapist In Private PracticeKY
-KY

Reviews

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Frequently asked questions

What number should I use to identify MR. JACOB RYAN DAVIS (MS, OTR/L) for billing?
Administrative and clinical systems typically use NPI 1417428350 for MR. JACOB RYAN DAVIS (MS, OTR/L).
Does the public listing show MR. JACOB RYAN DAVIS (MS, OTR/L) as active?
MR. JACOB RYAN DAVIS (MS, OTR/L)'s NPI record reflects an active status in NPPES.
What type of care does MR. JACOB RYAN DAVIS (MS, OTR/L) provide?
MR. JACOB RYAN DAVIS (MS, OTR/L)'s profile centers on Occupational Therapist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MR. JACOB RYAN DAVIS (MS, OTR/L)?
MR. JACOB RYAN DAVIS (MS, OTR/L) is associated with Georgetown, Kentucky 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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