Active NPI
Jacobs Audiology LLC
- Medical Specialty Clinic/Center
- Prince Frederick, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Specialty Clinic/Center
- License
- 000676 MD
- Legal business name
- JACOBS AUDIOLOGY LLC
- Practice address
- 131 Main St
Ste 202
Prince Frederick, MD 20678-3336 - Phone
- (410) 535-0024
- NPI assigned
- Oct 24, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marcia Jacobs
- Title
- Owner
- Phone
- (301) 633-0906
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | 000676 MD | MD | Primary |
Addresses
Primary practice location
131 Main St
Ste 202
Prince Frederick, MD 20678-3336
Mailing address
10 Cedarwood CT
Rockville, MD 20852-3406
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150326001292 | MD | Part B Supplier - Clinic/Group Practice | 4688851298 |
Receives reassigned benefits from 3 practitioners 1 other NPI on this enrollment Practice locations: Lexington Park, MD; Waldorf, MD |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
22738 Maple Rd
Ste 109
Lexington Pk, MD 20653
Phone (301) 860-1124
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Audiologist
- Bowie, MD
- NPI 1306140199
-
- Audiologist
- Lexington Park, MD
- NPI 1598448219
-
- Audiologist
- Bowie, MD
- NPI 1184390650
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414108800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1427328000000",
"number": "1194120808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 CEDARWOOD CT",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208523406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 MAIN ST",
"address_2": "STE 202",
"city": "PRINCE FREDERICK",
"state": "MD",
"postal_code": "206783336",
"telephone_number": "410-535-0024"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JACOBS AUDIOLOGY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-10-24",
"last_updated": "2015-03-26",
"status": "A",
"authorized_official_last_name": "JACOBS",
"authorized_official_first_name": "MARCIA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "301-633-0906"
},
"taxonomies": [
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": "MD",
"license": "000676 MD",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prince Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.