Active NPI
Luke Anthony Jacobson, PHARMD
- Pharmacist
- Ishpeming, MI
National Provider Identifier
1083491096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302415468
- Practice address
- 1330 US Highway 41 W
Ishpeming, MI 49849-3152 - Phone
- (906) 485-5592
- NPI assigned
- Sep 12, 2023
- Last updated
- Sep 12, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302415468 | MI | Primary |
Addresses
Primary practice location
1330 US Highway 41 W
Ishpeming, MI 49849-3152
Mailing address
316 North Rd
Negaunee, MI 49866-9505
Phone (906) 204-4810
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302415468 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694476800000",
"number": "1083491096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 NORTH RD",
"city": "NEGAUNEE",
"state": "MI",
"postal_code": "498669505",
"telephone_number": "906-204-4810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 US HIGHWAY 41 W",
"city": "ISHPEMING",
"state": "MI",
"postal_code": "498493152",
"telephone_number": "906-485-5592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "LUKE",
"middle_name": "ANTHONY",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-12",
"last_updated": "2023-09-12",
"certification_date": "2023-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302415468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ishpeming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.