JACE EVAN SHARP (DPT) – Physical Therapist, NPI 1245662550

JACE EVAN SHARP (DPT) is a healthcare provider. based in Wagoner, Oklahoma. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 4722 (OK). The NPI Number for JACE EVAN SHARP (DPT) is 1245662550

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
JACE EVAN SHARP (DPT)
NPI
1245662550
Phone
(918) 485-1212
Address
1200 W CHEROKEE ST
Enumeration Date
8 August 2013
Last Update Date
4 January 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9184855514
Graduation Year
2013 (13 years ago)
PAC ID
4385878610
Group Practice PAC ID
0042217531
Professional Enrollment ID
I20130927000634
Address ID
OK744674624WA1200XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

845 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OK

Provider Addresses for JACE EVAN SHARP (DPT)

  • 1200 W CHEROKEE ST

    WAGONER, OK 744674624

    Phone: (918) 485-1212

    Fax: (918) 485-1335

    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: 2013-09-27

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
I20130927000634IPhysical Therapist In Private PracticeOKTBD

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 minutes34212$0
View full utilization report →

Insurance plans in this area (ZIP 74467)

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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: 0042217531View full group profile
NameSpecialtyState
General Surgery, Thoracic Surgery, Vascular SurgeryMO
G A S T R O E N T E R O L O G YOK
Family Practice, Emergency MedicineOK
Family PracticeOK
Infectious DiseaseOK
Otolaryngology, Allergy/ImmunologyOK
Orthopedic SurgeryAR
Family Practice, Emergency MedicineOK
-OK
Psychiatry, Geriatric PsychiatryOK

Reviews

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Frequently asked questions

Can I verify JACE EVAN SHARP (DPT) with an NPI only?
You can start verification with NPI 1245662550 for JACE EVAN SHARP (DPT), then check state licensing separately.
Does the file indicate JACE EVAN SHARP (DPT) is practicing under active NPI?
Directory data currently reports JACE EVAN SHARP (DPT) as active.
What taxonomy line describes JACE EVAN SHARP (DPT)?
For research purposes, treat JACE EVAN SHARP (DPT) as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for JACE EVAN SHARP (DPT)?
JACE EVAN SHARP (DPT)'s geographic hint is Wagoner, Oklahoma in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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