Heather Suzanna Jacobs, RN, MPH, MSN, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP4640 Issued in AZ

Practice address

10750 W McDowell Rd
Suite G700
Avondale, AZ 85392-5960

Phone

(623) 873-0321

NPI assigned

Aug 31, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: hjacobs@wvpeds.directbygreenway.com

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

• Mountain View Pediatrics

  • Pediatrics Physician
  • Flagstaff, AZ
  • NPI 1366562944
  NPD (past)
• West Valley Pediatrics, P.C.

  • Pediatrics Physician
  • Avondale, AZ
  • NPI 1619195971
  NPD (past)
• West Valley Pediatrics, P.C.

  • Pediatrics Physician
  • Avondale, AZ
  • NPI 1750890075
  NPD (past)

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1639428014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10750 W MCDOWELL RD",
            "address_2": "SUITE G700",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925960",
            "telephone_number": "623-873-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10750 W MCDOWELL RD",
            "address_2": "SUITE G700",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925960",
            "telephone_number": "623-873-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "HEATHER",
        "middle_name": "SUZANNA",
        "name_prefix": "Ms.",
        "credential": "RN, MPH, MSN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-31",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "AP4640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gates Jackson
• Katherine Jackson
• Kiara Jackson
• Melvin Jackson
• Shasa Jackson, LCSW, DBH
• Trudy Jacobs
• Amaris Shanelle James
• Ketura James
• Kobe M Jamison, BA, RBT
• Michelle Roxanne Jamison, RN

• Pediatric Nurse Practitioner in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Pediatric Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; 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.