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

Jacob Carlson

Individual provider Physical Therapist · NPI 1710761069

Jacob Carlson is a Physical Therapist in Private Practice in Fort Benning, Georgia. Qualified in 2023, 3 years ago. Practices with Foothills Sports Medicine and Rehabilitation LLC, a 173-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
3
Licensed in
SC
In the registry since
2023
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Practice location Address checks out

6600 Van Aalst Blvd
Fort Benning, GA 31905-2102
Phone: (762) 408-2273
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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 12528 (SC)

Record details

NPI number1710761069
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 18, 2023
Last updated in NPPESMay 21, 2026
Certification dateMay 21, 2026
Mailing address6600 Van Aalst Blvd, Fort Benning, GA 31905-2102

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Foothills Sports Medicine And Rehabilitation Llc — 173 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fort Benning