JACOB DICKERSON – Physical Therapist, NPI 1730853292

JACOB DICKERSON is a healthcare provider. based in Louisville, Kentucky. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 008310 (KY). The NPI Number for JACOB DICKERSON is 1730853292

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
JACOB DICKERSON
NPI
1730853292
Phone
Not provided
Address
808 DANA MARIE DR
Enumeration Date
6 August 2021
Last Update Date
6 August 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5028994760
Graduation Year
2021 (5 years ago)
PAC ID
3476958950
Group Practice PAC ID
1850789066
Professional Enrollment ID
I20210820002389
Address ID
KY402071295LO6008XBLVD401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness55
Years active:4State licenses:1Phone numberDigital endpoints

1,255 PHYSICAL THERAPIST IN PRIVATE PRACTICE in KY

Provider Addresses for JACOB DICKERSON

  • 808 DANA MARIE DR

    LOUISVILLE, KY 402233408

    Phone:

    Type: Mailing

  • 6008 BROWNSBORO PARK BLVD

    LOUISVILLE, KY 402071295

    Phone:

    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: 2021-08-20

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
I20210820002389IPhysical 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 minutes2,086109$0
97140Therapy procedure using manual technique, each 15 minutes1,635107$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care99693$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes49149$0
97530Therapy procedure using functional activities33131$0
View full utilization report →

Insurance plans in this area (ZIP 40223)

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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: 1850789066View full group profile
NameSpecialtyState
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeKY
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeKY
Physical Therapist In Private PracticeKY
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeKY
Physical Therapist In Private PracticeFL

Reviews

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Frequently asked questions

Can I use this page to confirm JACOB DICKERSON's NPI?
Yes. JACOB DICKERSON is listed with NPI 1730853292 in the public NPI dataset.
Can I rely on JACOB DICKERSON being an active provider?
As of the registry snapshot, JACOB DICKERSON is marked active.
What is JACOB DICKERSON's specialty?
The listing groups JACOB DICKERSON with Physical Therapist. Clinical services aligned with this taxonomy classification.
Does JACOB DICKERSON list a practice location?
Patients near Louisville, Kentucky may find JACOB DICKERSON in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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