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

Jacob Melvin, PTA

Individual provider Physical Therapy Assistant · NPI 1841182581

Jacob Melvin, PTA is an Undefined Non-Physician Type (Specify) in Fairfax, Virginia. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Virginia.

Years since qualifying
1
Licensed in
VA
In the registry since
2025
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

10521 Rosehaven St Ste LL150
Fairfax, VA 22030-2889
Phone: (703) 383-1616
Fax: (703) 383-1166
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2306606772 (VA)

Record details

NPI number1841182581
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorYes
NPI enumeratedJuly 17, 2025
Last updated in NPPESJuly 17, 2025
Certification dateJuly 17, 2025
Mailing address10521 Rosehaven St Ste Ll150, Fairfax, VA 22030-2889

Medicare enrollment

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

Medicare specialtyUNDEFINED NON-PHYSICIAN TYPE (SPECIFY)
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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