Jodie Jacobs, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA345 Issued in ME

Practice address

259 Main St
Yarmouth, ME 04096-6723

Phone

(207) 846-9013

Fax

(207) 523-8586

NPI assigned

Mar 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Intermed, PA

  • Pediatrics Physician
  • South Portland, ME
  • NPI 1295607836
  NPD (past)
• Intermed, PA

  • Internal Medicine Physician
  • South Portland, ME
  • NPI 1467422733
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1023087251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FODEN RD WEST",
            "address_2": "STE 203",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062327",
            "telephone_number": "207-828-0361",
            "fax_number": "207-874-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 MAIN ST",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966723",
            "telephone_number": "207-846-9013",
            "fax_number": "207-523-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JODIE",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independence Home Care LLC
• Insight Eyecare PA
• Integrative Health Solutions Inc
• Intermed, PA
• J.Kelley Salon
• Stephen B Jacobs, MD
• Linda Margaret Jacobus, LMFT
• John J. Lowery, D.O., PH.D.
• Andrew Johnson, PT
• Chelsea Kate Johnson, PT, DPT

• Physician Assistant in Yarmouth, ME
• Providers in Yarmouth, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.