Kristen Ayana Jacobs, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2003023205 Issued in MO

Practice address

2700 Clay Edwards Dr
Suite 500
North Kansas City, MO 64116-3251

Phone

(816) 421-4115

Fax

(816) 421-4152

NPI assigned

Jan 23, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Lawrence Pediatrics P.a.

  • Pediatrics Physician
  • Lawrence, KS
  • NPI 1679853527
  NPD (past)

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185753600000",
    "number": "1124098280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9411 N OAK TRFY",
            "address_2": "SUITE LL1",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641552262",
            "telephone_number": "816-436-7072",
            "fax_number": "816-436-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 CLAY EDWARDS DR",
            "address_2": "SUITE 500",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163251",
            "telephone_number": "816-421-4115",
            "fax_number": "816-421-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "KRISTEN",
        "middle_name": "AYANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2007-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2003023205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208443606",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KC INDIVIDUAL",
            "identifier": "33110014",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelyn Rose Ingram
• Jennah Ann Irsik, AGACNP-BC
• Kelly Rae Isabell, PTA
• Emad F Israel, MD
• Roger P Jackson, M.D.
• James S. Zarr, MD, PC
• Jeff Laferla Vision Institute, OD PC
• Alison Johnson, RN, BSN, MSN, NP-C
• Kendall Johnson, D.O.
• Mary Daniel Johnson, RD

• Pediatrics Physician in North Kansas City, MO
• Providers in North Kansas City, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; 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.