Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michael Gene Jacketta, MPT, OCS

Individual provider Physical Therapist · NPI 1134131055

Michael Gene Jacketta, MPT, OCS is a Physical Therapist in Private Practice in Evanston, Wyoming. Qualified in 1998, 28 years ago. Practices with Wyoming Specialized Physical Therapy Inc, a 2-clinician group and accepts Medicare assignment. Licensed in Wyoming.

Years since qualifying
28
Licensed in
WY
In the registry since
2006
What do these letters mean?
MPT — Master of Physical Therapy
The master's-level physical therapy degree awarded before the DPT became standard.

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Practice location Address checks out

620 W Cheyenne Dr
Evanston, WY 82930-5359
Phone: (307) 789-8860
Fax: (307) 789-8394
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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 840 (WY)

Record details

NPI number1134131055
Entity typeIndividual (Type 1)
GenderMale
Credentials MPT , OCS
Sole proprietorNo
NPI enumeratedAugust 12, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Group practice Wyoming Specialized Physical Therapy Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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