Organization Active NPI

James J Jakubchak MD PA

  • Ophthalmology Physician
  • Spartanburg, SC
National Provider Identifier
1356522122
Registry record updated Aug 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
JAMES J JAKUBCHAK MD PA
Practice address
1330 Boiling Springs Rd
Suite 2400
Spartanburg, SC 29303
Phone
(864) 583-5312
Fax
(864) 582-1935
NPI assigned
Nov 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2008

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

Authorized official

Name
Dr. James Joseph Jakubchak, M.D.
Title
M.D.
Phone
(864) 583-5312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X SC Primary

Addresses

Primary practice location

1330 Boiling Springs Rd
Suite 2400
Spartanburg, SC 29303

Mailing address

1330 Boiling Springs Rd
Suite 2400
Spartanburg, SC 29303
Phone (864) 583-5312

Other identifiers 2

IdentifierTypeStateIssuer
CB9630OtherRAILROAD MEDICARE
085339MedicaidSC

National Provider Directory

National Provider Directory

Locations

125 Dillon Dr
Spartanburg, SC 29307
Phone (864) 585-6477

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1356522122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 BOILING SPRINGS RD",
            "address_2": "SUITE 2400",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29303",
            "telephone_number": "864-583-5312",
            "fax_number": "864-582-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BOILING SPRINGS RD",
            "address_2": "SUITE 2400",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29303",
            "telephone_number": "864-583-5312",
            "fax_number": "864-582-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES J JAKUBCHAK MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "JAKUBCHAK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "864-583-5312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB9630",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085339",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.