Holly Jacobsen, PTA

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

225200000X Issued in VA

Practice address

15075 Capital One Dr
Richmond, VA 23238-1122

Phone

(804) 855-6000

Fax

(804) 548-2035

NPI assigned

Dec 31, 2014

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Premise Health of Virginia Medical PC

  • Urgent Care Clinic/Center
  • Richmond, VA
  • NPI 1932543741
  NPD (past)

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

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1124416920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15075 CAPITAL ONE DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232381122",
            "telephone_number": "804-855-6000",
            "fax_number": "804-548-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15075 CAPITAL ONE DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232381122",
            "telephone_number": "804-855-6000",
            "fax_number": "804-548-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "HOLLY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-31",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "VA",
            "license": "225200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Jacobs, PT, DPT
• Henry J.R. Jacobs, CSA
• Marti G Jacobs, PHD
• Taylor Harrison Jacobs, MD
• Daniel Allen Jacobsen, MSW
• Kelly Aswad Jacobson, SLP
• Natalie Jacobson, PA-C
• Kristin Dahl Jacoby, MS PT
• David Michael Jaconski, ATC
• Jacqueline Johnson Curl DDS PC

• Physical Therapy Clinic/Center in Richmond, VA
• Providers in Richmond, VA by specialty
• Physical Therapy Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; 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.