Organization Active NPI

R. Daniel Jacob, M.D.,a.P.M.C.

  • Otolaryngology Physician
  • Metairie, LA
National Provider Identifier
1063661718
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD.012606 Issued in LA
Legal business name
R. DANIEL JACOB, M.D.,A.P.M.C.
Practice address
4228 Houma Blvd
Suite 340
Metairie, LA 70006-3000
Phone
(504) 454-3611
Fax
(504) 888-9452
NPI assigned
Sep 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Authorized official

Name
Rudolph Daniel Jacob, M.D.
Title
President
Phone
(504) 454-3611

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X MD.012606 LA Primary
Pediatric Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YP0228X MD.012606 LA
Sleep Medicine (Otolaryngology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YS0012X MD.012606 LA
Facial Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YS0123X MD.012606 LA
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0007X MD.012606 LA
Otolaryngic Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0602X MD.012606 LA
Otology & Neurotology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0901X MD.012606 LA
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0905X MD.012606 LA

Addresses

Primary practice location

4228 Houma Blvd
Suite 340
Metairie, LA 70006-3000

Mailing address

351 Vincent Ave
Metairie, LA 70005-4419
Phone (504) 454-3611

National Provider Directory

National Provider Directory

Locations

4228 Houma Blvd
Ste 340
Metairie, LA 70006
Phone (504) 454-3611

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1063661718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 VINCENT AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700054419",
            "telephone_number": "504-454-3611",
            "fax_number": "504-888-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 HOUMA BLVD",
            "address_2": "SUITE 340",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700063000",
            "telephone_number": "504-454-3611",
            "fax_number": "504-888-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R. DANIEL JACOB, M.D.,A.P.M.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "RUDOLPH",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-454-3611",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "MD.012606",
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "LA",
            "license": "MD.012606",
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "LA",
            "license": "MD.012606",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "LA",
            "license": "MD.012606",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "LA",
            "license": "MD.012606",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "LA",
            "license": "MD.012606",
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "LA",
            "license": "MD.012606",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "LA",
            "license": "MD.012606",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.