Active NPI
Brennan Kaine Jacobs, PHARMD
- Pharmacist
- Elmendorf Afb, AK
National Provider Identifier
1548730724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0022391
- Practice address
- 5955 Zeamer Ave
Elmendorf Afb, AK 99506-3702 - Phone
- (907) 580-6800
- NPI assigned
- Nov 29, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0022391 | CO | Primary |
| Pharmacist | 183500000X | 66806 | MT |
Addresses
Primary practice location
5955 Zeamer Ave
Elmendorf Afb, AK 99506-3702
Mailing address
5955 Zeamer Ave
Elmendorf Afb, AK 99506-3702
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0022391 | CO | MD | Pharmacist |
| 66806 | MT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726012800000",
"number": "1548730724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5955 ZEAMER AVE",
"city": "ELMENDORF AFB",
"state": "AK",
"postal_code": "995063702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5955 ZEAMER AVE",
"city": "ELMENDORF AFB",
"state": "AK",
"postal_code": "995063702",
"telephone_number": "907-580-6800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "BRENNAN",
"middle_name": "KAINE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-29",
"last_updated": "2024-09-11",
"certification_date": "2024-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "0022391",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MT",
"license": "66806",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmendorf Afb, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.