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

Jacob R Buchanan, DPT

Individual provider Physical Therapist · NPI 1780333245

Jacob R Buchanan, DPT is a Physical Therapist in Private Practice in O Fallon, Missouri. Qualified in 2022, 4 years ago. Practices with Athletico Ltd, a 2,186-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
4
Licensed in
MO
In the registry since
2022
Specialties on file
2
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

951 Waterbury Falls Dr
O Fallon, MO 63368-2202
Phone: (636) 336-0300
Fax: (636) 336-0297
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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 2022027510 (MO)
Physical Therapist Taxonomy 225100000X (MO)

Record details

NPI number1780333245
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedMarch 22, 2022
Last updated in NPPESOctober 12, 2022
Certification dateOctober 12, 2022
Mailing address2122 York Rd Ste 300, Oak Brook, IL 60523-1925

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Athletico Ltd — 2186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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