Molly Jacobs, FNP
Individual provider Active NPI Nurse Practitioner · Arcata, CA
NPI 1487983433 · NPPES record last updated Dec 20, 2016
Key facts
- NPI
- 1487983433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 22060 (CA)
- Practice address
- 3800 Janes Rd
Suite 101
Arcata, CA 95521-4742 - Phone
- (707) 822-1385
- Fax
- (707) 825-8203
- NPI assigned
- Dec 21, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Open Door Community Health Centers
Practice addresses (Care Compare)
1150 Foster Ave
Arcata, CA 95521-5986
Phone (707) 826-8610
770 10TH St
Arcata, CA 95521-6210
Phone (707) 826-8610
Hospital & facility affiliations
- Mad River Community Hospital
- Providence St Joseph Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120904000417 | CA | Practitioner - Nurse Practitioner | 9931356573 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Open Door Community Health Centers | Current |
Accepting new patients | |
| Open Door Community Health Centers | Current |
Accepting new patients | |
| Open Door Community Health Centers | Current | Accepting new patients | |
| Open Door Community Health Centers | Current | Accepting new patients | |
| Open Door Community Health Centers | Current | Accepting new patients |
Locations
785 18th St
Arcata, CA 95521
Phone (707) 822-2481
3800 Janes Rd
#101
Arcata, CA 95521
Phone (707) 822-1385
1275 8th St
Arcata, CA 95521
770 10th St
Arcata, CA 95521
Phone (707) 826-8610
550 E Washington Blvd
Crescent City, CA 95531
Phone (707) 465-4636
2200 Tydd St
Eureka, CA 95501
Phone (707) 269-7051
1644 Central Ave
McKinleyville, CA 95519
Phone (707) 839-3068
670 9th St
Ste 203
McKinleyville, CA 95521
Interoperability endpoints
- mjacobs13713@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 727816 | CA | |
| Nurse Practitioner | 363L00000X | 22060 | CA | Yes |
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | 22060 | CA | |
| Family Nurse Practitioner | 363LF0000X | 22060 | CA |
Addresses
Primary practice location
3800 Janes Rd
Suite 101
Arcata, CA 95521-4742
Mailing address
670 9TH St
Suite 203
Arcata, CA 95521-6248
Phone (707) 826-8633
Other providers in Arcata, CA
- Lianna Elizabeth Iniguez
- Evan Jackson
- Jennifer Ann Jackson
- Krystal Jacob
- Joseph Simpson Jacobs
- Jade Dragon Medical Spa
- Erik J Jansson
- John G Jaso
- Ian Jewett
- Patrick Jimenez
All providers in Arcata, CA · Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.