Active NPI
Rebecca Ariel Jacob, AUD
- Audiologist
- Hartford, CT
National Provider Identifier
1639695315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 4715-SP--AU
- Practice address
- 282 Washington St Ste 2F
Hartford, CT 06106-3322 - Phone
- (860) 545-9642
- NPI assigned
- Aug 15, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 4715-SP--AU | MA | Primary |
Addresses
Primary practice location
282 Washington St Ste 2F
Hartford, CT 06106-3322
Mailing address
282 Washington St Ste 2F
Hartford, CT 06106-3322
Phone (267) 229-5812
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 |
|---|---|---|---|
| 4715-SP--AU | MA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1639695315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "282 WASHINGTON ST STE 2F",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061063322",
"telephone_number": "267-229-5812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "282 WASHINGTON ST STE 2F",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061063322",
"telephone_number": "860-545-9642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "REBECCA",
"middle_name": "ARIEL",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-15",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MA",
"license": "4715-SP--AU",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.