Lynn Marie Jacoby, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

33770 Issued in AZ

Practice address

559 Vincent St
21 MDG/Bdaa Pediatrics
Colorado Springs, CO 80914-1541

Phone

(719) 556-1145

NPI assigned

Aug 31, 2006

Last updated

Oct 24, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224806400000",
    "number": "1205947546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST",
            "address_2": "21 MDG/BDAA PEDIATRICS",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809141541",
            "telephone_number": "719-556-1145",
            "fax_number": "866-867-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST",
            "address_2": "21 MDG/BDAA PEDIATRICS",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809141541",
            "telephone_number": "719-556-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "LYNN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "33770",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "33770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Denise Jacobsen, RN
• Susan Marie Jacobsen, ATR-BC, LPC
• Alicia Vashti Jacobson, RBT
• Ammon Jacobson, D.C.
• Garrett Jacobson
• Teresa Jacoby
• Laura Jacumski, PTA
• Jade Dental Professionals
• Jade Dental Professionals
• Nolan James Jaeger, MD

• Pediatrics Physician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Pediatrics Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.