Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Braden Gage Jackson

Individual provider Physical Therapist · NPI 1124830419

Braden Gage Jackson is a Physical Therapist in Private Practice in Lexington, Kentucky. Qualified in 2024, 2 years ago. Practices with Drayer Physical Therapy Kentucky LLC, a 12-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
2
Licensed in
KY
In the registry since
2025
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Practice location Address checks out

1010 Monarch St Ste 150
Lexington, KY 40513-1892
Phone: (859) 219-0211
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 009273 (KY)

Record details

NPI number1124830419
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 23, 2025
Last updated in NPPESFebruary 5, 2025
Certification dateFebruary 5, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Drayer Physical Therapy Kentucky Llc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Lexington