NPIMap

Individual provider Active NPI

Josette Jacobs, ACNP

  • Acute Care Nurse Practitioner
  • Reston, VA
National Provider Identifier
1538809926
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0024183988 Issued in VA
Practice address
11701 N Shore Dr
Reston, VA 20190-4504
Phone
(602) 509-0679
NPI assigned
Apr 1, 2022
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0024183988 VA Primary

Addresses

Primary practice location

11701 N Shore Dr
Reston, VA 20190-4504

Mailing address

11701 N Shore Dr
Reston, VA 20190-4504
Phone (602) 509-0679

Other practice location 1

8700 Sudley Rd
Manassas, VA 20110-4418
Phone (703) 396-5292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220624000345 VA Practitioner - Nurse Practitioner 5890174635 Reassigns benefits to 2 organizations
I20260427003550 DC Practitioner - Nurse Practitioner 5890174635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

101 Hospital Ctr Blvd
Stafford, VA 22554-6200
Phone (540) 741-9299

4320 Seminary Rd
Alexandria, VA 22304-1535
Phone (703) 504-3000

8503 Arlington Blvd
Fairfax, VA 22031-4628
Phone (703) 970-2670

8700 Sudley Rd
Manassas, VA 20110-4418
Phone (703) 396-5297

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024183988VAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians CurrentSince May 23, 2022 Accepting new patients
Uva Community Health Medical Group, LLC CurrentSince Jul 14, 2024 Accepting new patients
Mary Washington Healthcare Physicians CurrentSince May 23, 2022 Accepting new patients
Uva Community Health Medical Group, LLC Past Accepting new patients

Locations

4105 Lewis and Clark Dr
Charlottesvle, VA 22911

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

101 Hospital Center Blvd
Stafford, VA 22554
Phone (540) 741-3340

Interoperability endpoints

  • Direct secure messaging: jjacobs635265@direct.healthsystem.virginia.edu
  • Direct secure messaging: jjacobs94007@marywashingtonhealthcare.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1538809926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11701 N SHORE DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904504",
            "telephone_number": "602-509-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 N SHORE DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201904504",
            "telephone_number": "602-509-0679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 Sudley Rd",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201104418",
            "country_code": "US",
            "telephone_number": "703-396-5292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JOSETTE",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024183988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.