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

Jake Blackburn, DPT

Individual provider Physical Therapist · NPI 1295611721

Jake Blackburn, DPT is a Physical Therapist in Private Practice in Chesterfield, Missouri. Qualified in 2025, 1 year ago. Practices with Advanced Training and Rehab LLC, a 30-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
1
Licensed in
MO
In the registry since
2025
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

14515 N Outer 40 Rd Ste 110
Chesterfield, MO 63017-5746
Phone: (314) 434-6060
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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 2025033478 (MO)

Record details

NPI number1295611721
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedAugust 12, 2025
Last updated in NPPESAugust 12, 2025
Certification dateAugust 12, 2025
Mailing address14515 N Outer 40 Rd Ste 110, Chesterfield, MO 63017-5746

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Advanced Training And Rehab Llc — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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