Individual provider Active NPI

Cori L Jacobson, CNM

  • Advanced Practice Midwife
  • Perrysburg, OH
National Provider Identifier
1093713992
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
NM-06073 Issued in OH
Practice address
Preston Place I 5180 Chappel Drive
Building B
Perrysburg, OH 43551-7288
Phone
(567) 585-0265
Fax
(419) 873-6188
NPI assigned
Jul 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 06073 OH
Advanced Practice Midwife 367A00000X NM-06073 OH Primary

Addresses

Primary practice location

Preston Place I 5180 Chappel Drive
Building B
Perrysburg, OH 43551-7288

Mailing address

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-8541

Other identifiers 7

IdentifierTypeStateIssuer
344428256OtherCABEECH STREET
000000201559OtherANTHEM
2223534MedicaidOH
05225OtherPARAMOUNT
344428256072OtherCARESOURCE
344428256OtherOHHEALTH NET
4285606MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cjacobson13413@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20060810000115 OH Practitioner - Certified Nurse Midwife (CNM) 4789687880 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

1601 Brigham Dr
Suite 150
Perrysburg, OH 43551-7120
Phone (419) 872-7246

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
06073OHMDMidwife
NM-06073OHMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Medical University of Ohio at Toledo Current Accepting new patients
The Toledo Hospital CurrentSince Sep 18, 2000 Accepting new patients
Memorial Professional Services LTD CurrentSince Apr 1, 2020 Accepting new patients
Consultants in Laboratory Medicine of Greater Toledo Current Accepting new patients
Haematology-Oncology Associates of Ohio and Michigan PC Current Accepting new patients
The Toledo Hospital Current Accepting new patients
University of Toledo Physicians LLC CurrentSince Jun 16, 2021 Accepting new patients
Promedica Central Physicians CurrentSince Jul 16, 2018 Accepting new patients
The Toledo Hospital CurrentSince Sep 18, 2000 Accepting new patients
Promedica Central Physicians CurrentSince Jul 16, 2018 Accepting new patients

Locations

715 S Taft Ave
Fremont, OH 43420
Phone (419) 332-7321

1922 Glen Springs Dr
Fremont, OH 43420
Phone (419) 333-2798

660 Beaver Creek Cir
Ste 200
Maumee, OH 43537
Phone (419) 891-6201

1601 Brigham Dr
Ste 150
Perrysburg, OH 43551
Phone (419) 794-7700

1620 Brigham Dr
Ste 220
Perrysburg, OH 43551
Phone (567) 585-0265

5180 Chappel Dr
Bldg B
Perrysburg, OH 43551
Phone (567) 585-0265

5855 Monroe St
Sylvania, OH 43560
Phone (419) 291-2273

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

3355 Glendale Ave
Toledo, OH 43614
Phone (419) 383-5614

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

3333 Glendale Ave
Toledo, OH 43614
Phone (419) 259-2000

2150 W Central Ave
Toledo, OH 43606
Phone (419) 291-2200

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

Interoperability endpoints

  • Direct secure messaging: cjacobson39284@direct.utoledo.edu

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1093713992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-291-8541",
            "fax_number": "419-480-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PRESTON PLACE I 5180 CHAPPEL DRIVE",
            "address_2": "BUILDING B",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435517288",
            "telephone_number": "567-585-0265",
            "fax_number": "419-873-6188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "CORI",
        "middle_name": "L",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "OH",
            "license": "06073",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OH",
            "license": "NM-06073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEECH STREET",
            "identifier": "344428256",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000201559",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2223534",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "05225",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "344428256072",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "344428256",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4285606",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjacobson13413@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.