Jami Mary Elizabeth Jacobsen, FNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

219044 Issued in AZ

Practice address

1550 E Florence Blvd Ste 104
Casa Grande, AZ 85122-4788

Phone

(520) 483-1698

NPI assigned

Nov 8, 2018

Last updated

Oct 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jami.jacobsen.1@29405.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Revive Health and Wellness LLC

  • Primary Care Clinic/Center
  • Casa Grande, AZ
  • NPI 1528742814
  Medicare reassignment NPD

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1609344464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 E FLORENCE BLVD STE 104",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224788",
            "telephone_number": "520-635-5318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 E FLORENCE BLVD STE 104",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224788",
            "telephone_number": "520-483-1698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "JAMI",
        "middle_name": "MARY ELIZABETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "219044",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "219044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J. Robert West, M.D., Inc (West Dermatology of Arizona)
• J&M Transportation, LLC (J&M VIP Shuttle Service)
• Farouk M Jaara, M.D.
• Jeffrey Alan Jackson, O.D.
• Russell Patrick Jackson
• William M Jaffe, DO
• Rebecca L James, NP
• Jean Letarte MD PLLC
• Elizabeth Belle Jeans, MD
• Kenneth D Jeffers, O.D.

• Family Medicine Physician in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.