Active NPI
Jeffrey Douglas Jacobson, PHARM.D
- Pharmacist
- Fargo, ND
National Provider Identifier
1245441492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4821
- Practice address
- 2400 32ND Ave S
Fargo, ND 58103-5800 - Phone
- (701) 234-9912
- Fax
- (701) 297-0807
- NPI assigned
- May 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4821 | ND | Primary |
Addresses
Primary practice location
2400 32ND Ave S
Fargo, ND 58103-5800
Mailing address
2301 34 1/2 Ave S
Fargo, ND 58104-6586
Phone (701) 277-8431
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4821 | ND | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253836800000",
"number": "1245441492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 34 1/2 AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581046586",
"telephone_number": "701-277-8431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 32ND AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581035800",
"telephone_number": "701-234-9912",
"fax_number": "701-297-0807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "JEFFREY",
"middle_name": "DOUGLAS",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-26",
"last_updated": "2009-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ND",
"license": "4821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.