Constance Jacob, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

78963 Issued in KS

Practice address

1919 N Amidon Ave Ste 130
Wichita, KS 67203-2118

Phone

(316) 660-7675

Fax

(316) 941-5075

NPI assigned

Sep 19, 2019

Last updated

Sep 19, 2019By 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

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psych-Aprn LLCGroup PAC ID 1850781287, 7 clinicians

County of SedgwickGroup PAC ID 2961304779, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Sedgwick

  dba Sedgwick County Health Department

  • Public Health or Welfare Agency
  • Wichita, KS
  • NPI 1629281373
  Medicare reassignment Care Compare group NPD
• Psych-Aprn, LLC

  • Community/Behavioral Health Agency
  • Wichita, KS
  • NPI 1083378228
  Medicare reassignment Care Compare group NPD
• Luminary Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Derby, KS
  • NPI 1437866084
  Medicare reassignment NPD
• County of Sedgwick

  dba COMCARE Addiction Treatment Services

  • Addiction (Substance Use Disorder) Counselor
  • Wichita, KS
  • NPI 1376624775
  NPD
• County of Sedgwick

  dba COMCARE of Sedgwick County

  • Community/Behavioral Health Agency
  • Wichita, KS
  • NPI 1982351706
  NPD (past)

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1639729726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 W 3RD ST N STE 600",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672021223",
            "telephone_number": "316-660-7600",
            "fax_number": "316-941-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 N AMIDON AVE STE 130",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672032118",
            "telephone_number": "316-660-7675",
            "fax_number": "316-941-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "CONSTANCE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "78963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew DV Jackson, DDS
• Megan J Jackson, RN
• Renee Jackson, RN, BSN
• Shawn Ian Jackson, MD
• Jacob Kresky LLC
• Joel Jacob, MD
• Nathan Jacobberger
• Amy Marie Jacobs, LMLP LCP
• Belinda J Jacobs, LMSW
• Brandon Joel Jacobs, TLMFT

• Nurse Practitioner in Wichita, KS
• Providers in Wichita, KS by specialty
• Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.