Jonathan Jacobs, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

45453 Issued in TN

Practice address

Ut College of Medicine 920 Madison Ave
Suite C50
Memphis, TN 38163-0001

Phone

(901) 448-5364

NPI assigned

Jun 25, 2007

Last updated

Jan 31, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjacobs50123@mlh.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatric Emergency Specialists, PC

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Memphis, TN
  • NPI 1760482434
  Medicare reassignment NPD
• Pediatric Sedation Specialists, PC

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Memphis, TN
  • NPI 1881686814
  Medicare reassignment NPD

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1700082948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 VINTON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045230",
            "telephone_number": "901-291-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UT COLLEGE OF MEDICINE 920 MADISON AVE",
            "address_2": "SUITE C50",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381630001",
            "telephone_number": "901-448-5364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "45453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Twanna Evette Jackson, APN, BC
• Veronica Jackson, CSW
• Veronica M Jackson, LPC MHSP
• Jacob and Sons
• Connor Christopher Jacob, MD
• Michael Jacobs
• Ranise M. Jacobs, M.S. AMFT
• Tim Jacobs, PHARMD
• Jennifer Jacobson, OT
• Jennifer L. Jacobson, PSY.D.

• Pediatrics Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.