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

Dr. Jacob Mitchell Boehme, DPT

Individual provider Physical Therapist · NPI 1952987190

Dr. Jacob Mitchell Boehme, DPT is a Physical Therapist in Private Practice in Gold Canyon, Arizona. Qualified in 2021, 5 years ago. Practices with Moore Physical Therapy PLC, a 13-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
5
Licensed in
AZ
In the registry since
2021
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

6021 S Kings Ranch Rd Ste 5
Gold Canyon, AZ 85118-4774
Phone: (480) 982-7948
Fax: (480) 982-9145
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2500 S Power Rd Ste 123, Mesa, AZ 85209-6688 — (480) 218-1344

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 31677 (AZ)

Record details

NPI number1952987190
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedMarch 18, 2021
Last updated in NPPESSeptember 16, 2024
Certification dateSeptember 16, 2024

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Moore Physical Therapy Plc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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