Jacob T Joseph MD PC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

0101034461 Issued in VA

Legal business name

JACOB T JOSEPH MD PC

Practice address

10721 Main St
Suite 1100
Fairfax, VA 22030-6914

Phone

(703) 273-4762

Fax

(703) 591-7719

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jacob T Joseph, MDNPI 1346332939

Title

President

Phone

(703) 273-4762

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

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

• Jacob T Joseph, M.D.

  • Adult Medicine Physician
  • Fairfax, VA
  • NPI 1346332939

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457472391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST",
            "address_2": "SUITE 1100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306914",
            "telephone_number": "703-273-4762",
            "fax_number": "703-591-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST",
            "address_2": "SUITE 1100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306914",
            "telephone_number": "703-273-4762",
            "fax_number": "703-591-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB T JOSEPH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-273-4762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "VA",
            "license": "0101034461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth William Jackson, MD
• Keshonna Jackson
• Linda Jackson
• Megan Nicole Jackson
• Simajah Dominique Jackson, LCSW
• Allyson Jacobi
• David Alan Jacobs, LPC
• Deana Jacobs, LCPC, CCTP
• Nicole Jacobs, PT, DPT
• Jacqueline A Jacobson, L.P.C.

• Adult Medicine Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Adult Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.