Organization Active NPI

Dr. Steve Jacobs, Optometrist

  • Optometrist
  • Blacksburg, VA
National Provider Identifier
1689049074
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000267 Issued in VA
Legal business name
DR. STEVE JACOBS, OPTOMETRIST
Practice address
620 N Main St
Suite 101
Blacksburg, VA 24060-3385
Phone
(540) 953-0136
Fax
(540) 953-1358
NPI assigned
Dec 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Authorized official

Name
Dr. Steve Jacobs, O.D.
Title
Optometrist/Owner
Phone
(540) 953-0136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 0618000267 VA Primary

Addresses

Primary practice location

620 N Main St
Suite 101
Blacksburg, VA 24060-3385

Mailing address

620 N Main St
Suite 101
Blacksburg, VA 24060-3385
Phone (540) 953-0136

Other identifiers 1

IdentifierTypeStateIssuer
9202609MedicaidVA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1689049074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N MAIN ST",
            "address_2": "SUITE 101",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240603385",
            "telephone_number": "540-953-0136",
            "fax_number": "540-953-1358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N MAIN ST",
            "address_2": "SUITE 101",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240603385",
            "telephone_number": "540-953-0136",
            "fax_number": "540-953-1358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. STEVE JACOBS, OPTOMETRIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "540-953-0136",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9202609",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.

Verify at the official NPI Registry.