Individual provider Active NPI

Julia Jacobs

  • Registered Nurse
  • Rego Park, NY
National Provider Identifier
1073865259
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
656565 Issued in NY
Practice address
6584 Austin St
Apt 4T
Rego Park, NY 11374-4622
Phone
(347) 684-2713
NPI assigned
Oct 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 656565 NY Primary

Addresses

Primary practice location

6584 Austin St
Apt 4T
Rego Park, NY 11374-4622

Mailing address

6584 Austin St
Apt 4T
Rego Park, NY 11374-4622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
656565NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1073865259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6584 AUSTIN ST",
            "address_2": "APT 4T",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6584 AUSTIN ST",
            "address_2": "APT 4T",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744622",
            "telephone_number": "347-684-2713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JULIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "656565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.