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

Jack Nicklaus Martin, DPT

Individual provider Physical Therapist · NPI 1942030002

Jack Nicklaus Martin, DPT is a Physical Therapist in Private Practice in Germantown, Tennessee. Qualified in 2024, 2 years ago. Practices with MSK Group PC, a 139-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
2
Licensed in
TN
In the registry since
2024
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

2100 Exeter Rd Ste 200
Germantown, TN 38138-3966
Phone: (901) 522-6440
Fax: (901) 757-2507
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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 15748 (TN)

Record details

NPI number1942030002
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedAugust 5, 2024
Last updated in NPPESAugust 12, 2024
Certification dateAugust 12, 2024
Mailing address2100 Exeter Rd Ste 200, Germantown, TN 38138-3966

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 Msk Group Pc — 139 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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