Jacob'S Well Holistic Services, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

JACOB'S WELL HOLISTIC SERVICES, LLC

Practice address

3200 Strong Ave
Kansas City, KS 66106-2116

Phone

(913) 262-0550

Fax

(913) 831-3048

NPI assigned

Nov 9, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Renee L. Roosa, APRN, FNP-BC, CHES

Title

Ceo

Phone

(816) 916-5902

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1295336915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 BALTIMORE AVE APT 1207",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641083418",
            "telephone_number": "816-916-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 STRONG AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661062116",
            "telephone_number": "913-262-0550",
            "fax_number": "913-831-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB'S WELL HOLISTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "ROOSA",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "816-916-5902",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN, FNP-BC, CHES"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan T Jackson, PHD, MSC
• Tara L Jackson, APRN
• Victoria Jackson, CNA
• James Seth Jacob, MD
• Megha Lilly Jacob
• Sarah Jacober, MD
• Nicole Jacobs, FNP-C
• Anne Monroe Jacobsen, M.D.
• Abdullah Jahangir, M.D.
• Daryoush Jahanian, MD

• Primary Care Clinic/Center in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Primary Care Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.