Jeffry Alan Jacobs, MEDICAL DOCTOR

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

2022007260 Issued in MO

Practice address

3608 Faraon St
Saint Joseph, MO 64506-3044

Phone

(816) 232-4417

NPI assigned

Apr 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN, OR2 enrollments

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 2

Specialty

Psychiatry

Education

University of New Mexico School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Medical GroupGroup PAC ID 9032023270, 256 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjacobs640014@direct.peacehealth.org

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.

• Peacehealth Medical Group

  • Family Medicine Physician
  • Eugene, OR
  • NPI 1447207287

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Peacehealth

  dba Peace Harbor Medical Center

  • Critical Access Hospital
  • Florence, OR
  • NPI 1578552402
  Medicare reassignment NPD
• Peacehealth

  dba Cottage Grove Community Medical CT

  • Critical Access Hospital
  • Cottage Grove, OR
  • NPI 1902892391

  TN

  Medicare reassignment NPD
• Peacehealth

  dba Peace Harbor Medical Center

  • Multi-Specialty Clinic/Center
  • Florence, OR
  • NPI 1982774378
  Medicare reassignment NPD
• Peacehealth

  dba Peace Harbor Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Florence, OR
  • NPI 1356459606
  Medicare reassignment
• Peacehealth

  dba Cottage Grove Community Medical CT

  • Medicare Defined Swing Bed Hospital Unit
  • Cottage Grove, OR
  • NPI 1609142595
  Medicare reassignment
• Compass Health

  • Community/Behavioral Health Agency
  • Everett, WA
  • NPI 1730136201
  NPD
• Peacehealth Medical Group Cottage Grove

  • Multi-Specialty Clinic/Center
  • Creswell, OR
  • NPI 1780631267
  NPD
• Cherokee Health Systems

  dba River Valley Health

  • Federally Qualified Health Center (FQHC)
  • Talbott, TN
  • NPI 1134128820

  Psychiatry

  NPD (past)
• Helen Ross McNabb Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Knoxville, TN
  • NPI 1659330686
  NPD (past)
• J. Sidney Alexander, M.D., P.C.

  • Psychiatry Physician
  • Knoxville, TN
  • NPI 1538204003
  NPD (past)
• Oslc Community Programs

  • Adolescent and Children Mental Health Clinic/Center
  • Eugene, OR
  • NPI 1295747186
  NPD (past)

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1063477545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12932 ORCHARD CROSSING LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379341222",
            "telephone_number": "865-202-2209",
            "fax_number": "865-321-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3608 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063044",
            "telephone_number": "816-232-4417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 S 4th Ave",
            "address_2": "Central Washington Comprehensive Mental Health",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "98902",
            "country_code": "US",
            "telephone_number": "509-575-4084",
            "fax_number": "509-576-4302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1170 Pearl St",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974013541",
            "country_code": "US",
            "telephone_number": "541-743-4340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JEFFRY",
        "middle_name": "ALAN",
        "credential": "MEDICAL DOCTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "35908KY",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD60579729",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD38701",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MO",
            "license": "2022007260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200108213",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jabbits, Inc. (Caregivers)
• Jameson Jackson
• Jarod Jackson
• Kaitlin Jackson
• Shauna R Jackson, APRN, FNP-C
• Kellen Jacobs, DPT
• Coral Jacobson, PLPC
• James Kline, PC (Kline Women's Health Care)
• Elizabeth James, MD
• Louis David Jamtgaard, M.D.

• Child & Adolescent Psychiatry Physician in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Child & Adolescent Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.