Active NPI
Amy Jacobs
- Ambulatory Care Pharmacist
- Dubuque, IA
National Provider Identifier
1508461377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 21413
- Practice address
- 350 N Grandview Ave
Dubuque, IA 52001-6392 - Phone
- (563) 589-2472
- Fax
- (563) 589-2616
- NPI assigned
- Dec 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 21413 | IA | Primary |
Addresses
Primary practice location
350 N Grandview Ave
Dubuque, IA 52001-6392
Mailing address
1255 S Grandview Ave
Dubuque, IA 52003-8717
Phone (612) 708-5231
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21413 | IA | MD | Ambulatory Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606780800000",
"number": "1508461377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1255 S GRANDVIEW AVE",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520038717",
"telephone_number": "612-708-5231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 N GRANDVIEW AVE",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520016392",
"telephone_number": "563-589-2472",
"fax_number": "563-589-2616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "AMY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-01",
"last_updated": "2020-12-01",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "IA",
"license": "21413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dubuque, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.