Active NPI
Beck Jacobsen, MD
- Family Medicine Physician
- Warwick, RI
National Provider Identifier
1265019178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- LP05384
- Practice address
- 455 Toll Gate Rd
Warwick, RI 02886-2759 - Phone
- (401) 737-7010
- NPI assigned
- Mar 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | LP05384 | RI | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
455 Toll Gate Rd
Warwick, RI 02886-2759
Mailing address
455 Toll Gate Rd
Warwick, RI 02886-2759
Other practice location 1
111 Brewster St
Pawtucket, RI 02860-4400
Phone (401) 729-2304
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624492800000",
"number": "1265019178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 TOLL GATE RD",
"city": "WARWICK",
"state": "RI",
"postal_code": "028862759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 TOLL GATE RD",
"city": "WARWICK",
"state": "RI",
"postal_code": "028862759",
"telephone_number": "401-737-7010"
}
],
"practiceLocations": [
{
"address_1": "111 Brewster St",
"address_purpose": "LOCATION",
"city": "Pawtucket",
"state": "RI",
"postal_code": "028604400",
"country_code": "US",
"telephone_number": "401-729-2304",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBSEN",
"first_name": "BECK",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-26",
"last_updated": "2021-06-24",
"certification_date": "2021-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "RI",
"license": "LP05384",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Warwick, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.