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

Jacob Kevin McDonald, PT

Individual provider Physical Therapist · NPI 1336597335

Jacob Kevin McDonald, PT is a Physical Therapist in Private Practice in De Pere, Wisconsin. Qualified in 2016, 10 years ago. Practices with St Vincent Hospital-Hospital Sisters-Third Order of St Francis, a 594-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
10
Licensed in
WI
In the registry since
2016
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1601 Lawrence Dr Ste 100
De Pere, WI 54115-3931
Phone: (920) 426-4700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1630 Commanche Ave, Green Bay, WI 54313-5753 — (920) 430-4750

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 13393-24 (WI)

Record details

NPI number1336597335
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedMay 31, 2016
Last updated in NPPESSeptember 28, 2022
Certification dateSeptember 28, 2022

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice St Vincent Hospital-Hospital Sisters-Third Order Of St Francis — 594 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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