Individual provider Active NPI

Constance Lynn Jacoby, D.C.

  • Chiropractor
  • Duluth, MN
National Provider Identifier
1487891008
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3764 Issued in MN
Practice address
205 W 2ND St Ste 300
Duluth, MN 55802-1928
Phone
(218) 940-4342
NPI assigned
Jan 20, 2009
Last updated
Nov 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3764 MN Primary

Addresses

Primary practice location

205 W 2ND St Ste 300
Duluth, MN 55802-1928

Mailing address

205 W 2ND St Ste 300
Duluth, MN 55802-1928
Phone (218) 940-4342

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090331000070 MN Practitioner - Chiropractic 5698832095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

205 W 2ND St
Suite 300
Duluth, MN 55802-1928
Phone (218) 940-4342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jacoby Chiropractic LLC Chiropractor CurrentSince Feb 26, 2007 Accepting new patients

Locations

205 W 2nd St
Ste 300
Duluth, MN 55802
Phone (218) 206-8512

32 E 1st St
Ste 330
Duluth, MN 55802
Phone (218) 940-4342

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1487891008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W 2ND ST STE 300",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021928",
            "telephone_number": "218-940-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W 2ND ST STE 300",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021928",
            "telephone_number": "218-940-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "CONSTANCE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-20",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.