Cassidy Lynne Jacobs, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

13700 David O Dodd Rd
Little Rock, AR 72210-2747

Phone

(501) 907-8200

NPI assigned

Nov 7, 2017

Last updated

Mar 27, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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

• Colonel Glenn Health and Rehab, LLC

  • Skilled Nursing Facility
  • Little Rock, AR
  • NPI 1962860445
  NPD
• James Eyecare Center, Inc

  • Optometrist
  • Little Rock, AR
  • NPI 1740405786
  NPD (past)

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1376056705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13700 DAVID O DODD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722102747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13700 DAVID O DODD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722102747",
            "telephone_number": "501-907-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 1st St Ste A",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941052661",
            "country_code": "US",
            "telephone_number": "415-840-0560",
            "fax_number": "415-779-8032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "CASSIDY",
        "middle_name": "LYNNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tony O'Neal Jackson
• Topeka Jackson, LMSW
• Whitney Erin Jackson, RBT
• Jacksonville Ep PLLC
• Angela Jacobs, FNP
• Dewayne Jacobs
• Jazmyne Jacobs, RN
• Meredith Jacobs
• Nathalie Jacobs
• Richard Jacobs, MD

• Physician Assistant in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.