Jon R Jacobs

Primary specialty

SpecialistTaxonomy code 174400000X

License

199702336 Issued in SC

Legal business name

JON R JACOBS

Practice address

9213 University Blvd Ste D
North Charleston, SC 29406-9145

Phone

(843) 797-6564

Fax

(843) 572-9165

NPI assigned

Apr 22, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Shannon Leigh Smith, RN

Title

Office Manager

Phone

(843) 797-6564

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1093989006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9213 UNIVERSITY BLVD STE D",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069145",
            "telephone_number": "843-797-6564",
            "fax_number": "843-572-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9213 UNIVERSITY BLVD STE D",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069145",
            "telephone_number": "843-797-6564",
            "fax_number": "843-572-9165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON R JACOBS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-797-6564",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "SC",
            "license": "199702336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "C611963397",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI- SINGLE PROVIDER",
            "identifier": "1568535953",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113004",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeb Stuart Johnston
• Rachel Johnston
• Cary Johnstone, LPC
• Joint Replacement Cin of South Carolina LLC
• Lorie Ann Jolly, LCSW
• Briana Jones, PHARMD
• Carol Gainey Bledsoe Jones, M.D.
• Caroline Schuler Jones
• Charles Francis Jones, R.PH.
• Darcy M Jones, P.T.

• Specialist in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.