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

Samuel Collins Jackson, DPT

Individual provider Physical Therapist · NPI 1811511199

Samuel Collins Jackson, DPT is a Physical Therapist in Private Practice in Greenville, South Carolina. Qualified in 2020, 6 years ago. Practices with Foundation Physical Therapy LLC, a 6-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
6
Licensed in
SC
In the registry since
2020
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

104 Mauldin Rd Ste B
Greenville, SC 29605-1221
Phone: (864) 214-6680
Fax: (864) 309-8043
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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 10222 (SC)

Record details

NPI number1811511199
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedJune 3, 2020
Last updated in NPPESJune 2, 2026
Certification dateJune 2, 2026

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Foundation Physical Therapy Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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