MEDICARE: JACOB HARRIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	43558	FL
2	225100000X	Physical Therapist	16935	TN

General Provider Information

NPI Number	:	1548111412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB HARRIS

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	816-492-2367
Fax Number	:

Provider Business Practice Location Address
First Line	:	8006 HIGHWAY 100
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37221-4212
Country	:	US
Telephone Number	:	615-994-1867
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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