DR. JACOB KELLEY FREDERICK DPT
NPI 1124811393
Physical Therapist in O Fallon, MO

Active since May 28, 2025
3074 WINGHAVEN BLVD, O FALLON, MO 63368(636) 265-4100 Get Directions Write a Review

NPPES record last updated: May 28, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Jacob Kelley Frederick Dpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACOB KELLEY FREDERICK DPT (NPI 1124811393) is an individual physical therapist in O Fallon, Missouri, licensed in Missouri (2025017762) and active in the NPI registry since May 2025.

NPPES Registry Identity

NPI1124811393
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameDR. JACOB KELLEY FREDERICKCredential: DPT
Location Address3074 WINGHAVEN BLVDO Fallon, MO 63368-3620
Mailing Address3513 Brookside Crossing DrSaint Charles, MO 63301-4901
Sole ProprietorNo
Enumeration DateMay 28, 2025
NPPES CertifiedMay 28, 2025
NPI 1124811393 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License Licensed in MO · 2025017762
Definition

Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:<ul><li>Diagnose and manage movement dysfunction and enhance physical and functional abilities.</li><li>Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.</li><li>Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.</li><li>Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.</li><li>Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.</li></ul>PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

3074 WINGHAVEN BLVD, O Fallon, MO 63368

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
3074 WINGHAVEN BLVD
O FALLON, MO 63368
Clinic/Center (Rehabilitation)
3074 WINGHAVEN BLVD
O FALLON, MO 63368
Clinic/Center (Physical Therapy)
3074 WINGHAVEN BLVD
O'FALLON, MO 63368
Physical Therapist
3074 WINGHAVEN BLVD
O FALLON, MO 63368

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Frederick's NPI number?

The NPI number for Jacob Frederick is 1124811393. It was assigned to this individual provider in the NPPES registry on May 28, 2025.

Where is Jacob Frederick located?

Jacob Frederick practices at 3074 Winghaven Blvd, O Fallon, MO 63368. The listed phone number is (636) 265-4100.

What is Jacob Frederick's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

When was this NPI record last updated?

The NPPES record for Jacob Frederick was last updated on May 28, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.