Active NPI
Jessica Jacobs
- Athletic Trainer
- Arp, TX
National Provider Identifier
1609581487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT9454
- Practice address
- 101 Toney Dr
Arp, TX 75750-5024 - Phone
- (903) 859-4917
- NPI assigned
- Jan 17, 2023
- Last updated
- Sep 30, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT9454 | TX | Primary |
Addresses
Primary practice location
101 Toney Dr
Arp, TX 75750-5024
Mailing address
2051 W Cumberland Rd Apt 811
Tyler, TX 75703-7855
Phone (405) 924-0551
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT9454 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759190400000",
"number": "1609581487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2051 W CUMBERLAND RD APT 811",
"city": "TYLER",
"state": "TX",
"postal_code": "757037855",
"telephone_number": "405-924-0551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 TONEY DR",
"city": "ARP",
"state": "TX",
"postal_code": "757505024",
"telephone_number": "903-859-4917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-17",
"last_updated": "2025-09-30",
"certification_date": "2025-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT9454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arp, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.