DR. JACOB AARON RUSSELL PT, DPT
NPI 1356228142
Physical Therapist in Benton, IL

Active since August 21, 2025
1104 W MAIN ST, BENTON, IL 62812(618) 439-3399(618) 439-4801 Get Directions Write a Review

NPPES record last updated: August 28, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jacob Aaron Russell Pt, Dpt NPPES

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

DR. JACOB AARON RUSSELL PT, DPT (NPI 1356228142) is an individual physical therapist in Benton, Illinois, licensed in Illinois (070029347) and active in the NPI registry since August 2025. He is a graduate of Other (2025).

NPPES Registry Identity

NPI1356228142
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameDR. JACOB AARON RUSSELLCredential: PT, DPT
Location Address1104 W MAIN STBenton, IL 62812-1565
Mailing Address1104 W Main StBenton, IL 62812-1565 · (618) 439-3399 · Fax (618) 439-4801
Fax(618) 439-4801
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 21, 2025
Last NPPES UpdateAugust 28, 2025
NPPES CertifiedAugust 28, 2025
NPI 1356228142 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 IL · 070029347
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:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • 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.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
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.
1104 W MAIN ST, Benton, IL 62812

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Jacob Aaron Russell Pt, Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2668947565
PECOS Enrollment IDI20260408002399

Other Providers at the Same Location NPPES 7

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

Clinic/Center (Physical Therapy)
1104 W MAIN ST
BENTON, IL 62812
Occupational Therapist
1104 W MAIN ST
BENTON, IL 62812
Physical Therapist
1104 W MAIN ST
BENTON, IL 62812
Specialist/Technologist (Athletic Trainer)
1104 W MAIN ST
BENTON, IL 62812
Occupational Therapist
1104 W MAIN ST
BENTON, IL 62812
Physical Therapist
1104 W MAIN ST
BENTON, IL 62812
Clinic/Center (Rehabilitation)
1104 W MAIN ST
BENTON, IL 62812

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 Russell's NPI number?

The NPI number for Jacob Russell is 1356228142. It was assigned to this individual provider in the NPPES registry on August 21, 2025.

Where is Jacob Russell located?

Jacob Russell practices at 1104 W Main St, Benton, IL 62812. The listed phone number is (618) 439-3399.

What is Jacob Russell's specialty?

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

Is Jacob Russell enrolled in Medicare?

Yes. Jacob Russell is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Russell was last updated on August 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.