Active NPI
Michael C Jacobs, RPH
- Pharmacist
- N Charleston, SC
National Provider Identifier
1598712895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5560
- Practice address
- 3725 Rivers Ave
Suite 2
N Charleston, SC 29405-7038 - Phone
- (843) 745-8650
- Fax
- (843) 554-5453
- NPI assigned
- May 30, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5560 | SC | Primary |
Addresses
Primary practice location
3725 Rivers Ave
Suite 2
N Charleston, SC 29405-7038
Mailing address
3725 Rivers Ave Ste 2
N Charleston, SC 29405-7072
Phone (843) 745-8650
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5560 | Other | SC | PHARMACIST |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5560 | SC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205884800000",
"number": "1598712895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3725 RIVERS AVE STE 2",
"city": "N CHARLESTON",
"state": "SC",
"postal_code": "294057072",
"telephone_number": "843-745-8650",
"fax_number": "843-554-5453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3725 RIVERS AVE",
"address_2": "SUITE 2",
"city": "N CHARLESTON",
"state": "SC",
"postal_code": "294057038",
"telephone_number": "843-745-8650",
"fax_number": "843-554-5453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "MICHAEL",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-30",
"last_updated": "2008-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "5560",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "5560",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in N Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.