Individual provider Active NPI

Patricia Ann Jacobs, LVN

  • Licensed Vocational Nurse
  • Wills Point, TX
National Provider Identifier
1306347703
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
231928 Issued in TX
Practice address
4883 VZCR 3812
Wills Point, TX 75169-7516
Phone
(469) 474-0800
NPI assigned
Feb 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 231928 TX Primary

Addresses

Primary practice location

4883 VZCR 3812
Wills Point, TX 75169-7516

Mailing address

PO Box 51
Elmo, TX 75118-0051
Phone (469) 474-0800

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
231928TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1306347703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51",
            "city": "ELMO",
            "state": "TX",
            "postal_code": "751180051",
            "telephone_number": "469-474-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4883 VZCR 3812",
            "city": "WILLS POINT",
            "state": "TX",
            "postal_code": "751697516",
            "telephone_number": "469-474-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-22",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "231928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wills Point, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; 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.