Kristen Jacobs, APRN CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.026506 Issued in OH

Practice address

1277 Som Center Road, Loft 9
Loft 9
Mayfield Heights, OH 44124-4412

Phone

(440) 840-2093

NPI assigned

Dec 8, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Practitioner

State licenses

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1285032201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1277 SOM CENTER RD # LOFT9",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441242050",
            "telephone_number": "440-840-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 SOM CENTER ROAD, LOFT 9",
            "address_2": "LOFT 9",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441244412",
            "telephone_number": "440-840-2093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5734 Amber Ct",
            "address_purpose": "LOCATION",
            "city": "Willoughby",
            "state": "OH",
            "postal_code": "440943062",
            "country_code": "US",
            "telephone_number": "440-840-2093",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4240 Cambridge Ct",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "44122",
            "country_code": "US",
            "telephone_number": "440-840-2093",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "757 Alpha Dr",
            "address_purpose": "LOCATION",
            "city": "Highland Hts",
            "state": "OH",
            "postal_code": "441432173",
            "country_code": "US",
            "telephone_number": "440-840-2093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "KRISTEN",
        "credential": "APRN CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-08",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "026506",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.026506",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN404818",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Mayfield Heights, OH
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.

Verify at the official NPI Registry.