Jacob Medford

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Practice address

1204 E Baseline Rd Ste 205
Tempe, AZ 85283-1453

Phone

(619) 708-1440

NPI assigned

Dec 18, 2021

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)

Not enrolled

Practice roles

Locations

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.

• Medford'S Home, LLC

  • Community/Behavioral Health Agency
  • Maricopa, AZ
  • NPI 1952938185
  NPD Authorized official
• Medfords Family Services LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Tempe, AZ
  • NPI 1215697297
  NPD Authorized official

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

{
    "created_epoch": "1639785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639785600000",
    "number": "1497415475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44276 W NEELY DR",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851389427",
            "telephone_number": "619-708-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 E BASELINE RD STE 205",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831453",
            "telephone_number": "619-708-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDFORD",
        "first_name": "JACOB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-18",
        "last_updated": "2021-12-18",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayley Jean Meacham, BCBA
• Donald Meador
• Med Ride LLC
• Medcore Supplies LLC
• Medex Group
• Medfords Family Services LLC
• Medi-Ssage Outreach
• Medical Equipment Solutions
• Medical Nutrition Services, LLC
• Medical510 LLC

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2021; 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.