NPIMap

Organization Active NPI

R. Y. Jacobson, OD

  • Optometrist
  • Fort Dodge, IA
National Provider Identifier
1700022084
Registry record updated Jan 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
01536 Issued in IA
Legal business name
R. Y. JACOBSON, OD
Practice address
1428 2ND Ave N
Fort Dodge, IA 50501-4119
Phone
(515) 573-1145
Fax
(515) 573-1028
NPI assigned
Dec 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2009

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

Authorized official

Name
Jody M Shanks
Title
Office Manager
Phone
(515) 573-1145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 01536 IA Primary

Addresses

Primary practice location

1428 2ND Ave N
Fort Dodge, IA 50501-4119

Mailing address

1428 2ND Ave N
Fort Dodge, IA 50501-4119
Phone (515) 573-1145

National Provider Directory

National Provider Directory
Tax ID family
Medical Arts Eyecare PLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231891200000",
    "number": "1700022084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 2ND AVE N",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505014119",
            "telephone_number": "515-573-1145",
            "fax_number": "515-573-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 2ND AVE N",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505014119",
            "telephone_number": "515-573-1145",
            "fax_number": "515-573-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R. Y. JACOBSON, OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-17",
        "last_updated": "2009-01-14",
        "status": "A",
        "authorized_official_last_name": "SHANKS",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "515-573-1145"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "01536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.