Jakob McIntosh

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

9141 Cypress Green Dr Ste 2
Jacksonville, FL 32256-2006

Phone

(904) 647-1849

Fax

(904) 647-2625

NPI assigned

Aug 12, 2021

Sex

Male

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

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 and National Provider Directory roles.

• Bloom Behavioral Solutions

  • Multi-Specialty Clinic/Center
  • Atlantic Beach, FL
  • NPI 1780088609
  NPD
• Bloom Behavioral Solutions, Inc.

  • Multi-Specialty Clinic/Center
  • Atlantic Beach, FL
  • NPI 1881953347
  NPD

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1649945528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 ATLANTIC BLVD",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322333311",
            "telephone_number": "904-647-1849",
            "fax_number": "904-647-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9141 CYPRESS GREEN DR STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322562006",
            "telephone_number": "904-647-1849",
            "fax_number": "904-647-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "JAKOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Christa McInnis, MD
• Sydney McInnis, DNP, APRN
• Bruce J McIntosh, M.D.
• Charles B. McIntosh, M.D.
• Daniel R McIntosh
• Kerry-Ann McIntosh, PHARMD.
• Mark Stephen McIntosh, M.D.
• Ariana McIntyre
• Brittany McIntyre, LCSW
• Catherine J. McIntyre, M.D.

• Behavior Technician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.