Shelby Jacobs, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R215893 Issued in MD

Practice address

37767 Market Dr Unit 2
Charlotte Hall, MD 20622-3198

Phone

(301) 884-0278

Fax

(301) 884-8663

NPI assigned

Jul 11, 2024

Last updated

Jul 11, 2024By the provider in NPPES

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

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shah Dermatology LLCGroup PAC ID 4587981550, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shelby.jacobscrnp.p2@direct.msmg.nextgenshare.com

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.

• Shah Dermatology LLC

  • Dermatology Physician
  • Charlotte Hall, MD
  • NPI 1760873194
  Medicare reassignment Care Compare group NPD
• Center for Vein Restoration MD LLC

  • Vascular Surgery Physician
  • Prince Frederick, MD
  • NPI 1912729211
  NPD (past)

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1538906094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 258",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206360258",
            "telephone_number": "301-884-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37767 MARKET DR UNIT 2",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206223198",
            "telephone_number": "301-884-0278",
            "fax_number": "301-884-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "SHELBY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R215893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hae Sook Kim DMD LLC (Tender Care Dentistry)
• Lisa McLeod Hamilton, LAC RN
• Thomas Hao, D.D.S.
• HMR of Maryland LLC (Charlotte Hall Veterans Home)
• Jennifer Houck, PTA
• Katherine Jane Janicek, M.S. CCC-SLP
• Angela Rose Johannes, C.R.N.P.
• Natasha Johnson, M.D.
• Jessica Jolly
• Aileen Kim, MD

• Nurse Practitioner in Charlotte Hall, MD
• Providers in Charlotte Hall, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.