Individual provider Active NPI

Jacob David Landers, PHD

  • Psychologist
  • Hilliard, OH
National Provider Identifier
1609658624
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
P.08761 Issued in OH
Practice address
3995 Cosgray Rd
Hilliard, OH 43026-9880
Phone
(614) 293-9600
Fax
(614) 366-1215
NPI assigned
Oct 16, 2023
Last updated
May 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P.08761 OH Primary

Addresses

Primary practice location

3995 Cosgray Rd
Hilliard, OH 43026-9880

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250520001903 OH Practitioner - Clinical Psychologist 2466986773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osu Psychiatry LLCGroup PAC ID 0749272714, 135 clinicians

Practice addresses (Care Compare)

1800 Zollinger Rd
FL 5
Columbus, OH 43221-2800
Phone (614) 293-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
P.08761OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Psychiatry, LLC CurrentSince Jun 1, 2025 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Oct 25, 2024 Accepting new patients
Osu General Internal Medicine LLC Psychologist PastSince Feb 1, 2026 Accepting new patients

Locations

1670 Upham Dr
Columbus, OH 43210
Phone (614) 293-4540

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

1800 Zollinger Rd
Fl 5
Upper Arlington, OH 43221
Phone (614) 293-7417

5000 W National Ave
Milwaukee, WI 53295

10000 W Innovation Dr
Ste 300
Wauwatosa, WI 53226

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1609658624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-9600",
            "fax_number": "614-366-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3995 COSGRAY RD",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430269880",
            "telephone_number": "614-293-9600",
            "fax_number": "614-366-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDERS",
        "first_name": "JACOB",
        "middle_name": "DAVID",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-16",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "P.08761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilliard, OH

Sources for this page

Verify at the official NPI Registry.