Stacie Leigh Jacobs

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA002059 Issued in GA

Practice address

3520 N Crossing Cir
Valdosta, GA 31602-1067

Phone

(229) 242-8394

NPI assigned

Jan 20, 2022

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11118/brand/5/csg/22/fhir/r4

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.

• Valdosta Orthopedic Associates PC

  • Orthopaedic Surgery Physician
  • Valdosta, GA
  • NPI 1053457457
  NPD

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1508518507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3527 N VALDOSTA RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 N CROSSING CIR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021067",
            "telephone_number": "229-242-8394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "STACIE",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA002059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jermika L Jackson, RBT
• Sarah L. Jackson, RD., LDN.
• Shetia Donyette Jackson, BSW
• Tiffany Lashun Jackson
• Toni Jackson
• Jason Jacoby
• Rohail Jameel
• Cindy Renee James, FNP-C
• Latasha James, LPN
• Maya James

• Physical Therapy Assistant in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.