Steven Eugene Jacobs, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10000243A Issued in IN

Practice address

600 N Jordan Ave
Bloomington, IN 47405-3190

Phone

(812) 855-1272

NPI assigned

Nov 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063599660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7860 N WEXFORD CT",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474089339",
            "telephone_number": "812-369-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N JORDAN AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474053190",
            "telephone_number": "812-855-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "STEVEN",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10000243A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Libby Jackson, RBT
• Sydney Sophia Lauren Jacob
• Cherish Hope Jacobs-Tuttle
• Ashton Jacobs, FNP-C
• Dinah F Jacobs, DPT
• Tina Lynne Jacobs, NP
• Jacqueline M Jordan LLC
• Samantha Nichole Jahnke, OD
• Manish Jain, MD
• Pravi Jain, RBT

• Medical Physician Assistant in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.