Individual provider Active NPI

Christina Estelle Jacoby, AGCNS-BC, DNP, WCC

  • Gerontology Nurse Practitioner
  • Santa Fe, NM
National Provider Identifier
1558248484
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
85540 Issued in NM
Practice address
250 E Alameda St
Santa Fe, NM 87501-2186
Phone
(505) 995-2128
NPI assigned
Aug 20, 2025
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 85540 NM Primary
Critical Care Medicine Registered Nurse 163WC0200X RN-87695 NM
Enterostomal Therapy Registered Nurse 163WE0900X RN-87695 NM

Addresses

Primary practice location

250 E Alameda St
Santa Fe, NM 87501-2186

Mailing address

3016 Walsh Loop SE
Rio Rancho, NM 87124-2960
Phone (813) 503-6467

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

LicenseStateTypeSpecialty
RN-87695NMMDEnterostomal Therapy Registered Nurse
85540NMMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1558248484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 WALSH LOOP SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871242960",
            "telephone_number": "813-503-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E ALAMEDA ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875012186",
            "telephone_number": "505-995-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "CHRISTINA",
        "middle_name": "ESTELLE",
        "name_prefix": "Dr.",
        "credential": "AGCNS-BC, DNP, WCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NM",
            "license": "85540",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NM",
            "license": "RN-87695",
            "primary": false
        },
        {
            "code": "163WE0900X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Enterostomal Therapy",
            "state": "NM",
            "license": "RN-87695",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.