Active NPI
George Jacobs, M.D.
- Specialist
- Gastonia, NC
National Provider Identifier
1720082258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 20920
- Practice address
- 1225 E Garrison Blvd
Gastonia, NC 28054-5115 - Phone
- (704) 865-7416
- Fax
- (704) 865-7232
- NPI assigned
- Jun 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 20920 | NC | Primary |
Addresses
Primary practice location
1225 E Garrison Blvd
Gastonia, NC 28054-5115
Mailing address
1225 E Garrison Blvd
Gastonia, NC 28054-5115
Phone (704) 865-7416
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7945577 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327881600000",
"number": "1720082258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 E GARRISON BLVD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280545115",
"telephone_number": "704-865-7416",
"fax_number": "704-865-7232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 E GARRISON BLVD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280545115",
"telephone_number": "704-865-7416",
"fax_number": "704-865-7232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2012-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "20920",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7945577",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.