NPIMap

Organization Active NPI

Harvey R. Jacobs

  • Clinic/Center
  • Somerset, NJ
National Provider Identifier
1669646642
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
25MD00105100 Issued in NJ
Legal business name
HARVEY R. JACOBS
Practice address
25 Clyde Rd
Suite 101
Somerset, NJ 08873-5038
Phone
(732) 873-1111
NPI assigned
Apr 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Authorized official

Name
Dr. Harvey Richard Jacobs, D.P.M.
Title
Owner
Phone
(732) 873-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 25MD00105100 NJ Primary

Addresses

Primary practice location

25 Clyde Rd
Suite 101
Somerset, NJ 08873-5038

Mailing address

25 Clyde Rd
Suite 101
Somerset, NJ 08873-5038
Phone (732) 873-1111

Other identifiers 1

IdentifierTypeStateIssuer
1240307MedicaidNJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1208736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1669646642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CLYDE RD",
            "address_2": "SUITE 101",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088735038",
            "telephone_number": "732-873-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CLYDE RD",
            "address_2": "SUITE 101",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088735038",
            "telephone_number": "732-873-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVEY R. JACOBS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-21",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "HARVEY",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-873-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "25MD00105100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1240307",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.