Deborah Jean Jacoby

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Practice address

115 W Willoway Dr
Boise, ID 83705-5937

Phone

(208) 345-6625

NPI assigned

Dec 15, 2020

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1508452491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 W PINE AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837034850",
            "telephone_number": "208-608-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W WILLOWAY DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837055937",
            "telephone_number": "208-345-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "DEBORAH",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Conlon Jacobs, LCPC
• Shallece Jacobs
• Eric S Jacobsen, M.D.
• Grant Jacobsen
• Lydia Jacobson, DPT
• Hannah Jacopian, DNP
• Kimberly M Jacovino, RN
• Jade Health Center Inc.
• Nicole Jaeggli, AUD
• Chelsea Jahn, LM, CPM

• Adult Care Home Facility in Boise, ID
• Providers in Boise, ID by specialty
• Adult Care Home Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.