Jacob Randolph Shattuck, PTA
NPI 1881352516ActiveIndividual· Physical Therapy Assistant· Rome, GA
Physical Therapy Assistant (PTA) in Rome, Georgia, licensed in GA and TX, with an NPI issued in November 2021.
Overview
| NPI | 1881352516 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PTA |
| Sole proprietor | No |
| NPI issued | Nov 30, 2021 |
| Last updated in NPPES | Nov 30, 2021 |
| Certified by provider | Nov 12, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapy Assistant Primary | 225200000X | CP008628A | GA |
| Physical Therapy Assistant | 225200000X | 2136779 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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All 22 physical therapist assistants in Rome · All physical therapist assistants in Georgia