Shawna Jacob, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

P.07800 Issued in OH

Practice address

2812 Mack Rd
Fairfield, OH 45014-5130

Phone

(513) 813-5327

NPI assigned

Jun 6, 2019

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

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

Specialty

Clinical Psychologist

Education

University of Cincinnati College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Path Neuropsychology, LLCGroup PAC ID 5698140275, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Path Neuropsychology, LLC

  • Clinical Neuropsychologist
  • Fairfield, OH
  • NPI 1427763945
  Medicare reassignment Care Compare group NPD Authorized official
• University of Cincinnati Physicians Company, LLC

  • Family Medicine Physician
  • Cincinnati, OH
  • NPI 1801840434
  Medicare reassignment NPD
• Riverhills Healthcare, Inc.

  • Neurological Surgery Physician
  • Cincinnati, OH
  • NPI 1740386440

  Clinical Neuropsychologist

  NPD (past)

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1104485929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 MACK RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145130",
            "telephone_number": "513-813-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 MACK RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145130",
            "telephone_number": "513-813-5327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4805 Montgomery Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452122280",
            "country_code": "US",
            "telephone_number": "513-791-8080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3113 Bellevue Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452193158",
            "country_code": "US",
            "telephone_number": "513-475-8285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SHAWNA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OH",
            "license": "P.07800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denita Lynn Jackson, LPN
• Johnny Jackson III
• Maijic C Jackson, LPN
• Pamela Jackson
• Tonya Jackson
• Lamont Bregg Jacobs, D.D.S., M.S.
• Jerome James, RN
• Nyesha Nicole James
• Shaka James, MD
• Jean G Janelle, MD

• Clinical Neuropsychologist in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Clinical Neuropsychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.