Mariamma M Jacob, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

557515 Issued in TX

Practice address

7800 Preston Rd Ste 300
Plano, TX 75024-3236

Phone

(972) 608-3800

Fax

(972) 608-3810

NPI assigned

Sep 18, 2012

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

Other names 1

• Mariamma M Thomas Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1073863023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 PRESTON RD STE 300",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243236",
            "telephone_number": "972-608-3800",
            "fax_number": "972-608-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 PRESTON RD STE 300",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243236",
            "telephone_number": "972-608-3800",
            "fax_number": "972-608-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "MARIAMMA",
        "middle_name": "M",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "557515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIAMMA",
            "last_name": "THOMAS",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• McKenna Jackson, MS, CCC/SLP
• Monica Jackson, NP
• Sydney Michelle Jackson, DPT, PT
• Cerin Daniel Jacob, DO
• Jasmine Jacob, MSN,APRN, FNP-C
• Arlene J Jacobs, M.D.
• Craig Jacobs, D.C.
• Rebecca Anderson Jacobs, PA-C
• Eric B Jacoby, M.D.
• Hope Ashley Jacoby, DPM

• Pediatric Nurse Practitioner in Plano, TX
• Providers in Plano, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.