Elizabeth D Jacobs, MA CCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

155 Issued in AK

Practice address

600 University Ave
Ste. 110
Fairbanks, AK 99709-3643

Phone

(907) 451-1067

NPI assigned

May 22, 2007

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

Other names 1

• Betsey Jacobs Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Conversation Station LLC

  • Speech-Language Pathologist
  • Fairbanks, AK
  • NPI 1013184316
  NPD (past) Authorized official
• Acca, Inc.

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1922212844
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209945600000",
    "number": "1154530103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 GREEN LEAF RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997256273",
            "telephone_number": "907-451-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 UNIVERSITY AVE",
            "address_2": "STE. 110",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093643",
            "telephone_number": "907-451-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "ELIZABETH",
        "middle_name": "D",
        "credential": "MA CCCSLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2008-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETSEY",
            "last_name": "JACOBS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Megan Jackson, FNP-C
• Nakea Jackson, PTA
• Rickale K Jackson
• Tanya L Jackson
• Vanessa Rachel Jackson, CDM
• Jennifer Jacobs, MD, MPH
• Raynard Michael Jacobs
• Sarah Jagers
• James a. Cerney,DDS,PC
• James R. Miears, DDS, PC

• Speech-Language Pathologist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Speech-Language Pathologist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.