Benjamin Jacobs

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801095780 Issued in MI

Practice address

2100 Raybrook St SE Ste 300
Grand Rapids, MI 49546-5783

Phone

(616) 235-5100

Fax

(616) 235-5050

NPI assigned

Dec 20, 2018

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

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Journey Christian Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Byron Center, MI
  • NPI 1326638867
  Medicare reassignment NPD
• Faith Palliative Care

  • Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
  • Grand Rapids, MI
  • NPI 1497014476
  NPD (past)

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1679045298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 RAYBROOK ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467759",
            "telephone_number": "616-235-5100",
            "fax_number": "616-235-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 RAYBROOK ST SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465783",
            "telephone_number": "616-235-5100",
            "fax_number": "616-235-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-20",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris Jacob, DO
• Frigga Ellen Fabay Jacob, MD
• Jemima Jacob
• Joseph Michael Porciuncula Jacob, MD
• Amy Michelle Jacobs
• Brooke Elizabeth Jacobs, LMSW-C
• Christina Veronica Jacobs, MD
• Doris A Jacobs, PA-C
• Jaelyn Anna-Louise Jacobs
• Jennifer Renee Jacobs

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.