Heidi L Jacobson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16508 Issued in OR

Practice address

310 E 6TH St
#202
Medford, OR 97501-5933

Phone

(541) 245-2787

Fax

(541) 899-3243

NPI assigned

Jan 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Heidi Leverenz Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Gastroenterology Consultants, PC

  • Gastroenterology Physician
  • Medford, OR
  • NPI 1639104136

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1689654022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E 6TH ST STE 202",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015943",
            "telephone_number": "458-225-2123",
            "fax_number": "541-482-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E 6TH ST",
            "address_2": "#202",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015933",
            "telephone_number": "541-245-2787",
            "fax_number": "541-899-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "HEIDI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "16508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE CROSS",
            "identifier": "005591010",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011895",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "LEVERENZ",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jacob O. Layer, DMD, PC
• Jeffrey T Jacob, DMD
• Rick Jacobs, PH D
• Tiffany Jacobs
• Karen Ann Jacobsen, RN
• Kris N Jacobson, MD
• Stephanie Ruth Jacobson
• Alissa Jacoby
• Jacqueline Amato MD PC
• Ross J Jacques, DPT

• All providers in Medford, OR
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.