Marci Medenwald Jacobsen, BS, BS, AAS

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT-A1207 Issued in AR

Practice address

4301 W Markham St
Little Rock, AR 72205-7101

Phone

(501) 686-8754

NPI assigned

Jun 29, 2007

Last updated

Mar 17, 2018By 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 1

Addresses

Other names 1

• Marci Kaye Medenwald Sullivan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Applied Science, Bachelor of Science

State licenses

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629275995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "972-400-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Quail Hollow Pl",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394028974",
            "country_code": "US",
            "telephone_number": "601-264-8987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "MARCI",
        "middle_name": "MEDENWALD",
        "name_prefix": "Mrs.",
        "credential": "BS, BS, AAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A1207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCI",
            "last_name": "MEDENWALD SULLIVAN",
            "middle_name": "KAYE",
            "credential": "BS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meredith Jacobs
• Nathalie Jacobs
• Richard Jacobs, MD
• Samantha Jacobs, OTR/L
• Sandee Miller Jacobs, APN
• Rachel A. Jacquez, APRN
• Lea Shannon Jacuzzi, DPT
• Rahul Jadhav, MBBS DMRD DNB
• Dharmikkumar Bharatbhai Jadvani
• Matthew W. Jaeger, MD

• Occupational Therapy Assistant in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Occupational Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.