Active NPI
Jameson Jacobs
- Pharmacist
- Fostoria, OH
National Provider Identifier
1396411617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03441057
- Practice address
- 113 N Countyline St
Fostoria, OH 44830-1766 - Phone
- (419) 435-7716
- NPI assigned
- Aug 17, 2021
- Last updated
- Aug 17, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03441057 | OH | Primary |
Addresses
Primary practice location
113 N Countyline St
Fostoria, OH 44830-1766
Mailing address
70 Township Road 14
Van Buren, OH 45889-9621
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03441057 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lane Drug Co | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629158400000",
"number": "1396411617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 TOWNSHIP ROAD 14",
"city": "VAN BUREN",
"state": "OH",
"postal_code": "458899621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 N COUNTYLINE ST",
"city": "FOSTORIA",
"state": "OH",
"postal_code": "448301766",
"telephone_number": "419-435-7716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "JAMESON",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-17",
"last_updated": "2021-08-17",
"certification_date": "2021-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03441057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fostoria, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.