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

Jason Douglas Gillam, MPT

Individual provider Physical Therapist · NPI 1740571595

Jason Douglas Gillam, MPT is registered under Physical Therapist in Private Practice in Fairbanks, Alaska. Qualified in 2003, 23 years ago. Practices with North Pole Physical Therapy Inc, a 16-clinician group and accepts Medicare assignment. Licensed in Alaska.

Years since qualifying
23
Licensed in
AK
In the registry since
2011
What do these letters mean?
MPT — Master of Physical Therapy
The master's-level physical therapy degree awarded before the DPT became standard.

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Practice location Address checks out

2310 Peger Rd Ste 101
Fairbanks, AK 99709-5315 Not confirmed with CMS for 15 years — call before visiting
Phone: (907) 457-7678
Fax: (907) 457-7677
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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 1531 (AK)

Record details

NPI number1740571595
Entity typeIndividual (Type 1)
GenderMale
Credentials MPT
Sole proprietorNo
NPI enumeratedApril 28, 2011
Last updated in NPPESApril 28, 2011

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice North Pole Physical Therapy Inc — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fairbanks