NPIMap

Individual provider Active NPI

Pamela N Jacobs, APRN

  • Primary Care Nurse Practitioner
  • Enosburg Falls, VT
National Provider Identifier
1700623576
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
101.0137220 Issued in VT
Practice address
382 Main St
Enosburg Falls, VT 05450-6008
Phone
(802) 933-5831
Fax
(802) 933-2362
NPI assigned
Jul 10, 2024
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 101.0137220 VT Primary

Addresses

Primary practice location

382 Main St
Enosburg Falls, VT 05450-6008

Mailing address

382 Main St
Enosburg Falls, VT 05450-6008
Phone (802) 933-5831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240802000339 VT Practitioner - Nurse Practitioner 5597202945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Vermont College of Medicine, 2024
Medicare assignment
May accept Medicare assignment
Group practices
The Richford Health Center, Inc.Group PAC ID 7012825631, 30 clinicians

Practice addresses (Care Compare)

3 Crest Rd
Saint Albans, VT 05478-9753
Phone (802) 524-4554

64 Industrial Park Rd
Alburg, VT 05440-4170
Phone (802) 796-4414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101.0137220VTMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Richford Health Center Inc Current Accepting new patients
The Richford Health Center Inc CurrentSince Jul 24, 2024 Accepting new patients
The Richford Health Center Inc CurrentSince Jul 24, 2024 Accepting new patients
The Richford Health Center Inc PastSince Sep 5, 2023 Accepting new patients
The Richford Health Center Inc Past Accepting new patients

Locations

44 Main St
Ste 200
Richford, VT 05476
Phone (802) 255-5500

Interoperability endpoints

  • Direct secure messaging: pjacobs@notch.medentdirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1700623576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 MAIN ST",
            "city": "ENOSBURG FALLS",
            "state": "VT",
            "postal_code": "054506008",
            "telephone_number": "802-933-5831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 MAIN ST",
            "city": "ENOSBURG FALLS",
            "state": "VT",
            "postal_code": "054506008",
            "telephone_number": "802-933-5831",
            "fax_number": "802-933-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "PAMELA",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VT",
            "license": "101.0137220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enosburg Falls, VT

Sources for this page

Verify at the official NPI Registry.