Individual provider Active NPI

Jacob Alexander Hass

  • Marriage & Family Therapist
  • Louisville, KY
National Provider Identifier
1427714005
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
10300 Brookridge Village Blvd Ste 104
Louisville, KY 40291-4474
Phone
(502) 785-4322
NPI assigned
Nov 9, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

10300 Brookridge Village Blvd Ste 104
Louisville, KY 40291-4474

Mailing address

309 W Shannon LN # D16
Shepherdsville, KY 40165-4919
Phone (502) 297-3093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20240515003766 KY Practitioner - Marriage and Family Therapist 0143661579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brock Family Therapy Center Inc.Group PAC ID 7315253416, 12 clinicians

Practice addresses (Care Compare)

10300 Brookridge Village Blvd
Suite 104
Louisville, KY 40291-4474
Phone (502) 785-4322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brock Family Therapy Center Inc. CurrentSince May 1, 2024 Accepting new patients

Locations

10300 Brookridge Village Blvd
Ste 104
Louisville, KY 40291
Phone (502) 727-8697

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1427714005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 W SHANNON LN # D16",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401654919",
            "telephone_number": "502-297-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 BROOKRIDGE VILLAGE BLVD STE 104",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402914474",
            "telephone_number": "502-785-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASS",
        "first_name": "JACOB",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.