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

Jacob David Miller

Individual provider Physical Therapist · NPI 1619647062

Jacob David Miller is a Physical Therapist in Private Practice in LA Crosse, Wisconsin. Qualified in 2021, 5 years ago. Practices with Capitol Physical Therapy Specialists LLC, a 23-clinician group and accepts Medicare assignment. Licensed in Minnesota and Wisconsin.

Years since qualifying
5
Licensed in
MN, WI
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

700 W Ave S
LA Crosse, WI 54601-4783
Phone: (608) 785-0940
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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 15624 (WI)
Physical Therapist Taxonomy 225100000X · Licence 12235 (MN)

Record details

NPI number1619647062
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 16, 2021
Last updated in NPPESJune 28, 2024
Certification dateJune 28, 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 Capitol Physical Therapy Specialists Llc — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in LA Crosse