Kelsy Jacobs, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN00146512 Issued in WA

Practice address

26928 120TH St E
Buckley, WA 98321-8565

Phone

(360) 829-5516

Fax

(260) 829-3351

NPI assigned

Oct 28, 2019

Last updated

Oct 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1659914174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26928 120TH ST E",
            "city": "BUCKLEY",
            "state": "WA",
            "postal_code": "983218565",
            "telephone_number": "360-829-5516",
            "fax_number": "360-829-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26928 120TH ST E",
            "city": "BUCKLEY",
            "state": "WA",
            "postal_code": "983218565",
            "telephone_number": "360-829-5516",
            "fax_number": "260-829-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "KELSY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00146512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjacobs@whiteriver.wednet.edu",
            "affiliation": "N",
            "address_1": "26928 120th St E",
            "city": "Buckley",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983218565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Registered Nurse in Buckley, WA
• Providers in Buckley, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.