Loran C Jacobs Jr PLLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN151239 Issued in AZ

Legal business name

LORAN C JACOBS JR PLLC

Practice address

807 S Ponderosa St
Payson, AZ 85541-5542

Phone

(602) 273-6770

Fax

(602) 889-0489

NPI assigned

Apr 4, 2008

Last updated

Apr 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Loran C. Jacobs Jr., CRNANPI 1144277575

Title

Sole Member

Phone

(602) 273-6770

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Loran C Jacobs Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Payson, AZ
  • NPI 1144277575
  Authorized official Same address or phone

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1255504791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29211",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850389211",
            "telephone_number": "602-273-6770",
            "fax_number": "602-889-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 S PONDEROSA ST",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415542",
            "telephone_number": "602-273-6770",
            "fax_number": "602-889-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORAN C JACOBS JR PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "LORAN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "602-273-6770",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "RN151239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Payson, AZ
• Providers in Payson, AZ by specialty
• Certified Registered Nurse Anesthetist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.