Mary Ann Jacob, M.D., LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

128883 Issued in AK

Legal business name

MARY ANN JACOB, M.D., LLC

Practice address

2841 Debarr Rd
Suite 45
Anchorage, AK 99508-2958

Phone

(907) 274-0274

NPI assigned

Jul 20, 2010

Organization subpart

No

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

Authorized official

Name

Mary Ann Jacob, M.D.NPI 1194741041

Title

Member/Manager

Phone

(907) 274-0274

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Ann Jacob, M.D.

  • Pediatrics Physician
  • Anchorage, AK
  • NPI 1194741041
  NPD (past) Authorized official

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1437462363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2841 DEBARR RD",
            "address_2": "SUITE 45",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2841 DEBARR RD",
            "address_2": "SUITE 45",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082958",
            "telephone_number": "907-274-0274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ANN JACOB, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-20",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "907-274-0274",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AK",
            "license": "128883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Marver
• Marvin John Grendahl MD a Professional Corp.
• Alicia Marvin, M.S.
• Arthur Jackson Marvin Jr.
• Robert Timothy Marx
• Mary Conrad Center
• Mary H Pomeroy
• Mary K Downs, MD
• Mary Margaret Hillstrand Anp, LLC
• Mary P. Demers, D.O., & Associates, LLC

• Pediatrics Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Pediatrics Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; 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.