Evan Michael Jacoby, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

R4747 Issued in KY

Practice address

245 Fountain CT
Lexington, KY 40509-1888

Phone

(859) 323-6861

Fax

(859) 323-1194

NPI assigned

Mar 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ejacoby22209@ukhcdirect.org

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.

• Baptist Health Medical Group Inc

  • Nurse Practitioner
  • Lexington, KY
  • NPI 1518360296

  Psychiatry

  Medicare reassignment NPD
• Baptist Health Medical Group Inc

  • Nurse Practitioner
  • Nicholasville, KY
  • NPI 1255805586
  NPD
• Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  NPD

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1497250062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 FOUNTAIN CT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091888",
            "telephone_number": "859-323-6021",
            "fax_number": "859-323-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 FOUNTAIN CT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091888",
            "telephone_number": "859-323-6861",
            "fax_number": "859-323-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "EVAN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "R4747",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "R4747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Jacobson
• Lynn Marie Jacobson, M.D.
• Mark S Jacobson, DDS
• Shanda Jacobson, RDH
• Delwin B. Jacoby, DNP, ARNP,
• Stephanie Nichelle Jadhav, MD
• Mary Caroline Jaeger
• Judith Jill Bowling Jaggers, APRN
• Sarah Marie Jagielski
• Samia Jahan, MD

• Psychiatry Physician in Lexington, KY
• Providers in Lexington, KY by specialty
• Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.