Caroline A Jacobus, RN

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

408240 Issued in NY

Practice address

1676 Sunset Ave
4TH Floor
Utica, NY 13502-5416

Phone

(315) 624-5622

Fax

(315) 624-5625

NPI assigned

Aug 15, 2008

Last updated

Aug 25, 2020By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1447406921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 GENESEE STREET",
            "address_2": "BUSINESS OFFICE ROOM 315",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015930",
            "telephone_number": "315-801-3282",
            "fax_number": "315-801-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1676 SUNSET AVE",
            "address_2": "4TH FLOOR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025416",
            "telephone_number": "315-624-5622",
            "fax_number": "315-624-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBUS",
        "first_name": "CAROLINE",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NY",
            "license": "408240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Joseph Jackson, D.D.S.
• Diane Jackson
• Susan M Jackson, FNP
• Erik J. Jacobson, PHD
• Jean M. Jacobson, PHD
• Sarah A Jacopino, FNP
• Anthony J Jadhon, M.D.
• Heather M Jadlowski, PT
• Julia Jaikin, DC
• Dejan Jakimovski, MD

• Diabetes Educator Registered Nurse in Utica, NY
• Providers in Utica, NY by specialty
• Diabetes Educator Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.