Jacob Comstock

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCSW-34156 Issued in ID

Practice address

412 W Pacific St
Blackfoot, ID 83221-1726

Phone

(208) 201-1743

NPI assigned

Apr 2, 2015

Last updated

Sep 28, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health West IncGroup PAC ID 4981500931, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Health West, Inc.

  dba Health West Preston Clinic

  • Federally Qualified Health Center (FQHC)
  • Preston, ID
  • NPI 1033595541
  Medicare reassignment Care Compare group NPD
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763

  ID

  Medicare reassignment NPD
• Health West, Inc.

  dba Health West Aberdeen Clinic

  • Federally Qualified Health Center (FQHC)
  • Aberdeen, ID
  • NPI 1295734796
  NPD
• Health West, Inc.

  dba Health West Downey Clinic

  • Federally Qualified Health Center (FQHC)
  • Downey, ID
  • NPI 1588666945
  NPD
• Health West, Inc.

  dba Health West American Falls Clinic

  • Federally Qualified Health Center (FQHC)
  • American Falls, ID
  • NPI 1629077235
  NPD
• Health West, Inc.

  dba Sryinga Elementary School

  • Federally Qualified Health Center (FQHC)
  • Pocatello, ID
  • NPI 1740143882
  NPD

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443398400000",
    "number": "1386039675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420E 25TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047549",
            "telephone_number": "208-542-1026",
            "fax_number": "208-528-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 W PACIFIC ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211726",
            "telephone_number": "208-201-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMSTOCK",
        "first_name": "JACOB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-02",
        "last_updated": "2015-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "LCSW-34156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Comfort Home Care
• Community Council of Idaho, Inc (Community Family Clinic Pharmacy)
• Community Council of Idaho, Inc. (Community Family Clinic)
• Community Council of Idaho, Inc. (Community Family Clinic Pharmacy)
• Complete Family Eye Care, PA
• Thomas Ray Cook
• Stacy Cooper, PA-C
• Alan E Crandall, PA-C
• Nicole Criddle, LMSW
• Crimson Sky Therapy PLLC

• Addiction (Substance Use Disorder) Counselor in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Addiction (Substance Use Disorder) Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.