Jenna Elizabeth Jacobson, MSN, RN, CPNP-AC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP018348 Issued in PA

Practice address

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Phone

(215) 590-1000

NPI assigned

Dec 14, 2017

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 names 1

• Miss Jenna Elizabeth Deangelis Former name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

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.

• Childrens Health Care Associates, Inc

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1598869059
  Medicare reassignment NPD
• Childen's Health Care Associates Inc.

  dba CHCA Nurse Practitioners

  • Pediatric Registered Nurse
  • Philadelphia, PA
  • NPI 1699860643
  NPD
• Childrens Health Care Associates, Inc

  dba CHCA Medical Toxicology

  • Pediatric Medical Toxicology Physician
  • Philadelphia, PA
  • NPI 1104911163
  NPD

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662163200000",
    "number": "1164938015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 WHITE ASH DR",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190478026",
            "telephone_number": "215-630-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "JENNA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "MSN, RN, CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-14",
        "last_updated": "2022-09-03",
        "certification_date": "2022-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP018348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "DEANGELIS",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alec Michael Jacobson, MD
• Emily Jacobson
• Eric Jacobson
• Irving Warren Jacobson, DMD
• Jeffrey M Jacobson, MD
• Jessica T Jacobson, COTA
• Julie E Jacobson, MS
• Kenneth L Jacobson, MD
• Mercedes Jacobson, MD
• Samuel David Jacobson, MD

• Pediatric Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.