Allen T Jacobs, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME64478 Issued in FL

Practice address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342

Phone

(855) 979-5700

Fax

(855) 979-5701

NPI assigned

May 2, 2006

Sex

Male

Sole proprietor

Yes

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

Doctor of Medicine

Practice roles

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.

• Cogent Healthcare of Fort Myers, LLC

  • Internal Medicine Physician
  • Ft Myers, FL
  • NPI 1952352163
  NPD (past)
• Internal Medicine Associates of Lee County Hospitalist Group, LLC

  • Hospitalist Physician
  • Fort Myers, FL
  • NPI 1033402185
  NPD (past)

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1467410464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "855-979-5700",
            "fax_number": "855-979-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "855-979-5700",
            "fax_number": "855-979-5701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5172 Mason Corbin Ct",
            "address_2": "SUITE 1",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339074540",
            "country_code": "US",
            "telephone_number": "239-936-7171",
            "fax_number": "239-936-7455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "ALLEN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME64478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy Ann Jackson, L.C.S.W.
• Renuka Jackson
• William T Jackson
• Kenneth Michael Jacob, MD
• Sha'Nariyah Jacob, RBT
• Bruce Paul Jacobs, RPH
• Darren R Jacobs, D.O.
• Randall S Jacobs, MD
• Robert G Jacoby, M.D.
• Mario Jacome Jr., DO

• Internal Medicine Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.