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

Jacob Sampson, PT

Individual provider Physical Therapist · NPI 1639954134

Jacob Sampson, PT is a Physical Therapist in Private Practice in Indianapolis, Indiana. Qualified in 2023, 3 years ago. Practices with Fast Track Physical Therapy LLC, a 12-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
3
Licensed in
IN
In the registry since
2023
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

5641 Crawfordsville Rd
Indianapolis, IN 46224-3718
Phone: (317) 524-8570
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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 05015279A (IN)

Record details

NPI number1639954134
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedAugust 31, 2023
Last updated in NPPESAugust 31, 2023
Certification dateAugust 31, 2023

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 Fast Track Physical Therapy Llc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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