Janet Jacob, ANP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

780 Issued in AK

Practice address

3340 Providence Dr
Suite 351
Anchorage, AK 99508-4691

Phone

(907) 212-4824

Fax

(907) 212-4831

NPI assigned

Sep 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: jjacob11396@ak.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• State of Alaska Department of Administration

  • Psychiatric Hospital
  • Anchorage, AK
  • NPI 1497842553
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1326149709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "866-907-1068",
            "fax_number": "425-917-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 PROVIDENCE DR",
            "address_2": "SUITE 351",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084691",
            "telephone_number": "907-212-4824",
            "fax_number": "907-212-4831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "JANET",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022728",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjacob11396@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "4100 Lake Otis Pkwy Ste 312",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995085231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tammy T. Jackson, FNP
• Tommy Dale Jackson Jr.
• Troy Anthony Jackson Jr.
• Yolanda Jackson, CARE COORDINATOR
• Jack Jacob, M.D.
• Mary Ann Jacob, M.D.
• Alicia J Jacobs
• Carl Jacobs
• Chelsey D Jacobs, PA-C
• Michael Ralph Jacobs

• Nurse Practitioner in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.