Ann Pilar Jacobson, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

828 Issued in KS

Practice address

10925 Antioch Rd Ste 103
Overland Park, KS 66210-2119

Phone

(913) 663-1763

Fax

(913) 469-0604

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2015 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Peabody,Inc.

  • Clinical Psychologist
  • Overland Park, KS
  • NPI 1992355143
  NPD (past) Authorized official
• Trauma Recovery Services, Inc.

  • Clinical Psychologist
  • Overland Park, KS
  • NPI 1316210982
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558414458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10925 ANTIOCH RD STE 103",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102119",
            "telephone_number": "913-663-1763",
            "fax_number": "913-469-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10925 ANTIOCH RD STE 103",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102119",
            "telephone_number": "913-663-1763",
            "fax_number": "913-469-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ANN",
        "middle_name": "PILAR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "828",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "01551",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Paige Jacobs
• Madison Jacobs, MS, RD, LD
• Sherri Ann Jacobs, LMFT-T
• Taylor Marie Jacobs, DC
• Amy Margaret Jacobsen, PH.D.
• Dana N Jacobson, AUD
• Mirjam Melody Jacobson
• Ethan Steed Jaeger, DO
• Raza S Jafri, M. D
• Jacob S Jagneaux, LPC

• Psychologist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.