Penny Lynn Jacobs, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R078476 Issued in MD

Practice address

University of Maryland Health Ctr
BLDG 140 Campus Dr
College Park, MD 20742-0001

Phone

(301) 314-8190

Fax

(301) 314-3596

NPI assigned

Apr 2, 2007

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

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.

Opted out of Medicare

Yes, effective Jul 1, 2016 through Jul 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1669593489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 OGLETHORPE ST",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207823026",
            "telephone_number": "301-779-8715",
            "fax_number": "301-314-3596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF MARYLAND HEALTH CTR",
            "address_2": "BLDG 140 CAMPUS DR",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207420001",
            "telephone_number": "301-314-8190",
            "fax_number": "301-314-3596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "PENNY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R078476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Insight Treatment Services (AARS Insight Treatment Centers)
• Institute for Life Enrichment
• Peace Lisa Chidima Iwuala
• Jasmine Gabrielle Jackson, PT
• Donna Francis Jacobs, NP
• Jill Berger Jacobson
• Abiodun Elizabeth Jaiyeola
• Isatu Jalloh
• Mariama Jalloh
• Jaroma Distinct Care Inc

• Family Nurse Practitioner in College Park, MD
• Providers in College Park, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.