Andrew A Jacobs, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

R0244 Issued in MO

Practice address

800 W 47TH St
Ste 514
Kansas City, MO 64112-1251

Phone

(816) 561-5556

Fax

(816) 756-3151

NPI assigned

Aug 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1073506226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W 47TH ST",
            "address_2": "STE 514",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121251",
            "telephone_number": "816-561-5556",
            "fax_number": "816-756-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 47TH ST",
            "address_2": "STE 514",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121251",
            "telephone_number": "816-561-5556",
            "fax_number": "816-756-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "ANDREW",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "R0244",
            "primary": true
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "MO",
            "license": "R0244",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "16045018",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dany Jacob, MD
• Justin Joseph Jacob, PHARMD
• Jacobs Well of Kansas City Ministries
• Jacobs Well of Kansas City Ministries
• Jacobs Well of Kansas City Ministries
• Bailey Jacobs
• Holly Jacobs, APRN
• Kala Jacobs, SSP
• Kristina Carlile Jacobs, LMSW
• Rachel Erin Jacobs, M.D.

• Psychologist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.