Erik Jacobsen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M0117 Issued in TX

Practice address

2600 Saint Michael Dr
Texarkana, TX 75503-2372

Phone

(903) 614-1000

NPI assigned

Jun 17, 2006

Sex

Male

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7280/brand/1/csg/1/fhir/r4
• Direct secure messaging: erik.jacobsen.1@7280.direct.athenahealth.com

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.

• Supracare Family Health PLLC

  • Primary Care Clinic/Center
  • New Boston, TX
  • NPI 1801234596
  Medicare reassignment NPD
• Emergency Associates of Texas, PA

  • Emergency Medicine Physician
  • Texarkana, TX
  • NPI 1326071788
  NPD (past)
• Texarkana Emergency Medicine Physicians,PA

  • Emergency Medicine Physician
  • Texarkana, TX
  • NPI 1184662553
  NPD (past)

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1376588210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2018",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787682018",
            "telephone_number": "512-305-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SAINT MICHAEL DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032372",
            "telephone_number": "903-614-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "ERIK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M0117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliet Noelle Jackson
• Noel R Jackson, CRNA
• Randy Alan Jackson, M.D.
• Job Jacob, M.D.
• Elizabeth Jean Jacobsen, FNP-C
• Jacqueline S O'Donald, M.D., PA
• James M Hurley MD PA (Texarkana Cardiology Associates)
• Joseph D James, D.D.S.
• Paul Mitchell James, CRNA
• Jay J Castle DDS PLLC (Castle Family Dental)

• Family Medicine Physician in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.