Active NPI
Adrienne Jacobs
- Registered Dietitian
- Ada, OK
National Provider Identifier
1679608186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1427
- Practice address
- 1921 Stonecipher Blvd
Ada, OK 74820 - Phone
- (580) 421-4570
- Fax
- (580) 421-6283
- NPI assigned
- Feb 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1427 | OK | Primary |
Addresses
Primary practice location
1921 Stonecipher Blvd
Ada, OK 74820
Mailing address
1921 Stonecipher Blvd
Ada, OK 74820
Phone (580) 421-4570
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427 | Other | OK | OK LICENSE |
Other names 1
- Adrienne Ferguson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1427 | OK | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435708800000",
"number": "1679608186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1921 STONECIPHER BLVD",
"city": "ADA",
"state": "OK",
"postal_code": "74820",
"telephone_number": "580-421-4570",
"fax_number": "580-421-6283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1921 STONECIPHER BLVD",
"city": "ADA",
"state": "OK",
"postal_code": "74820",
"telephone_number": "580-421-4570",
"fax_number": "580-421-6283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "ADRIENNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-23",
"last_updated": "2015-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "1427",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OK LICENSE",
"identifier": "1427",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ADRIENNE",
"last_name": "FERGUSON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Ada, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.