Gwendolyn Jacob

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

000000004960 Issued in AR

Practice address

5343 Highway 1 S
Jonesboro, AR 72404-7588

Phone

(870) 623-9985

NPI assigned

Feb 21, 2024

Last updated

Feb 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Transfer Global Transportation LLC

  • Non-emergency Medical Transport (VAN)
  • Jonesboro, AR
  • NPI 1538927876
  NPD Authorized official

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1255197919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5343 HIGHWAY 1 S",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724047588",
            "telephone_number": "870-623-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5343 HIGHWAY 1 S",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724047588",
            "telephone_number": "870-623-9985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "GWENDOLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "AR",
            "license": "000000004960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas M Jackson, DMD, MSD
• Tieawauna Jackson, MHPP
• Vernetha Jackson
• Wesley Jackson
• Aniefiok Jacob
• Alexa Jacobs
• Cameron Jacobs, QBHP
• Emily Jacobs, M.D.
• Jasmine Marie Jacobs
• James B Phillips, Ms, DDS, PA

• Non-emergency Medical Transport (VAN) in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Non-emergency Medical Transport (VAN) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.