IndividualActive
Jim Jacob, PT
NPI 1790767887 · Physical Therapist · Plymouth, IN
Provider details
- NPI number
- 1790767887
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PT
- Sex
- Male
- Sole proprietor
- No
- License
- 05008652A (IN)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES 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
900 W Jefferson St
Plymouth, IN 46563-1634
Phone: (574) 936-9600
Fax: (574) 936-9612
Street-level locationGet directions
Mailing address
Po Box 308
Mishawaka, IN 46546-0308
Registry dates
- Enumerated
- 2005-11-15
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.