Jaclyn Fantom
NPI 1053296673 · Physical Therapist · Philadelphia, PA
Jaclyn Fantom is a Physical Therapist provider in Philadelphia, PA (NPI 1053296673).
Provider details
- NPI number
- 1053296673
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- PT033564 (PA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-08-11
- Last updated
- 2025-08-13
- Certified
- 2025-08-13
Frequently asked questions
- What is Jaclyn Fantom's NPI number?
- Jaclyn Fantom's National Provider Identifier (NPI) is 1053296673, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jaclyn Fantom's specialty?
- Jaclyn Fantom is listed in the NPPES registry with a primary specialty of Physical Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Jaclyn Fantom located?
- Jaclyn Fantom's practice location on file with NPPES is 2410 S Broad St Ste 101, Philadelphia, PA 19145-4418.
- What is Jaclyn Fantom's phone number?
- The practice phone number listed in the NPPES registry for Jaclyn Fantom is (215) 334-4400.
- Is Jaclyn Fantom's NPI active?
- Yes — Jaclyn Fantom's NPI (1053296673) is active in the NPPES registry as of the last update on 2025-08-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.