Individual provider Active NPI

Christopher Dewayne Jacobs

  • Peer Specialist
  • Greensboro, NC
National Provider Identifier
1194639153
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
1 Centerview Dr Ste 102
Greensboro, NC 27407-3712
Phone
(336) 285-5204
NPI assigned
Sep 29, 2026
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X NC Primary

Addresses

Primary practice location

1 Centerview Dr Ste 102
Greensboro, NC 27407-3712

Mailing address

4407 Crowne Lake Cir Apt 2a
Jamestown, NC 27282-7964
Phone (743) 337-3139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1194639153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4407 CROWNE LAKE CIR APT 2A",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272827964",
            "telephone_number": "743-337-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CENTERVIEW DR STE 102",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274073712",
            "telephone_number": "336-285-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "CHRISTOPHER",
        "middle_name": "DEWAYNE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-29",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.