Active NPI
Mark Jacobi, M.D.
- Pediatrics Physician
- Michigan City, IN
National Provider Identifier
1598735607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01027648A
- Practice address
- 1225 E Coolspring Ave
Michigan City, IN 46360-6312 - Phone
- (219) 878-5037
- Fax
- (219) 873-2931
- NPI assigned
- Jan 23, 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01027648A | IN | Primary |
Addresses
Primary practice location
1225 E Coolspring Ave
Michigan City, IN 46360-6312
Mailing address
1040 Sierra Dr
Ste 400
Greenwood, IN 46143-7240
Phone (317) 528-4248
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100162940 | Medicaid | IN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01027648A | IN | MD | Pediatrics Physician |
Interoperability endpoints
- djacobi5751@direct.franciscanalliance.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321401600000",
"number": "1598735607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 SIERRA DR",
"address_2": "STE 400",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461437240",
"telephone_number": "317-528-4248",
"fax_number": "317-865-8314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 E COOLSPRING AVE",
"city": "MICHIGAN CITY",
"state": "IN",
"postal_code": "463606312",
"telephone_number": "219-878-5037",
"fax_number": "219-873-2931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBI",
"first_name": "MARK",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2011-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01027648A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100162940",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Michigan City, IN
- Indiana Institute of Cardiology
- Indiana University Health la Porte Hospital Inc
- Indiana University Health la Porte Hospital Inc
- John Alexander Israel, PSY.D
- Catherine Sheila Jackson-Evans, MD, FACOG
- Neel Pramod Jain, M.D.
- James H Timmons, DDS
- James O. Hartson, MD, LLC
- James R. McCormick DDS
- Theresa V Jarvis, OT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.