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

Mr. Kyle Jackson, PT

Individual provider Physical Therapist · NPI 1861597908

Mr. Kyle Jackson, PT is a Physical Therapist in Private Practice in Petaluma, California. Qualified in 2001, 25 years ago. Practices with Next Level Physical Therapy Inc, a 2-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
25
Licensed in
CA
In the registry since
2006
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

1310 Casa Grande Rd Ste B
Petaluma, CA 94954-5603
Phone: (707) 782-0921
Fax: (707) 782-0926
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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 PT27666 (CA)

Record details

NPI number1861597908
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedSeptember 13, 2006
Last updated in NPPESJuly 9, 2007
Mailing addressPo Box 10, Windsor, CA 95492-0010

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Next Level Physical Therapy Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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