Kraig Warren Jacobson, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

09759 Issued in OR

Practice address

1488 Oak St
Eugene, OR 97401-4043

Phone

(541) 683-1577

Fax

(541) 344-6176

NPI assigned

Aug 22, 2005

Last updated

Dec 28, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Praxis Health, PC

  • Multi-Specialty Clinic/Center
  • Bend, OR
  • NPI 1821068164
  Medicare reassignment NPD
• Oak Street Medical P.C.

  dba Oregon Allergy Associates

  • Allergy & Immunology Physician
  • Eugene, OR
  • NPI 1144212499
  Authorized official Same address or phone
• Praxis Health, PC

  dba Dallas Family Care

  • Rural Health Clinic/Center
  • Dallas, OR
  • NPI 1942925326
  NPD

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1255323515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 OAK ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014043",
            "telephone_number": "541-683-1577",
            "fax_number": "541-344-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 OAK ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014043",
            "telephone_number": "541-683-1577",
            "fax_number": "541-344-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "KRAIG",
        "middle_name": "WARREN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "OR",
            "license": "09759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234468",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mikel Alexander Jacobo, QMHA
• Aaron Gabriel Jacobs
• Aaron Michael Jacobs
• Robert Montagu Jacobs, MA
• Kirk Douglas Jacobson, M.D.
• Melissa Michelle Jacobson, B.E.D.
• Susan Diane Jacobson, LPN
• Mary Jacque, B.S.
• Sunil Jacques
• Alison N Jaderquist, MSW

• Allergy & Immunology Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Allergy & Immunology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.