Joseph Michael Iacobucci, RN, MSN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN294205 Issued in GA

Practice address

700 19TH St S
Birmingham, AL 35233-1927

Phone

(205) 933-8101

NPI assigned

Nov 21, 2022

Last updated

Sep 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1114636081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LEXINGTON VLG",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696857",
            "telephone_number": "678-628-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331927",
            "telephone_number": "205-933-8101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Lexington Vlg",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302696857",
            "country_code": "US",
            "telephone_number": "678-628-3877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IACOBUCCI",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "RN, MSN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-21",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN294205",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN294205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.