Judith L. Jacobus, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD044442E Issued in PA

Legal business name

JUDITH L. JACOBUS, M.D.

Practice address

1701 12TH Ave. BLDG F
Altoona, PA 16601

Phone

(814) 944-8012

Fax

(814) 944-4852

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Miss Judith L Jacobus, M.D.

Title

Owner

Phone

(814) 944-8012

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1013047133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 HAREWOOD RD NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200171511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 12TH AVE. BLDG F",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "16601",
            "telephone_number": "814-944-8012",
            "fax_number": "814-944-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDITH L. JACOBUS, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "JACOBUS",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-944-8012",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD044442E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012014890005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Altoona, PA
• Providers in Altoona, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.