Jacoby Jacobsen, D.O.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

11722081-1204 Issued in UT

Practice address

2213 Cherry St
Toledo, OH 43608-2603

Phone

(419) 251-6596

Fax

(419) 251-6849

NPI assigned

Mar 2, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjacobsen458178@direct.med.utah.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shriners Hospitals for Children

  • Pediatric Orthopaedic Surgery Physician
  • Salt Lake City, UT
  • NPI 1396187282
  Medicare reassignment NPD
• University of Utah Pediatric Services

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1487018974
  Medicare reassignment NPD
• University of Utah Pediatric Services

  • Pediatric Infectious Diseases Physician
  • Salt Lake City, UT
  • NPI 1285098855
  NPD
• University of Utah Pediatric Services

  • Child & Adolescent Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1386008852
  NPD
• University of Utah Pediatric Services

  • Pediatrics Physician
  • Riverton, UT
  • NPI 1043671985
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1003231952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "419-251-6596",
            "fax_number": "419-251-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "419-251-6596",
            "fax_number": "419-251-6849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "JACOBY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-02",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": "11722081-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjacobsen458178@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Jacobs, MOT, OTR/L
• Lori A Jacobs, FNP-C
• Loyd A Jacobs, M.D.
• Marissa Kay Jacobs
• Ronda Jacobs
• Haley Jacobson
• Jordan Jacobson, LAT, ATC
• Jennifer Lee Jacoby, CRNA
• Jacqueline F Jackson
• Ralf Jadoopat

• Orthopaedic Surgery Physician in Toledo, OH
• Providers in Toledo, OH by specialty
• Orthopaedic Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.