Jennifer Jacobson, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN 106778 AP1265 Issued in AZ

Practice address

6812 N Oracle Rd
114
Tucson, AZ 85704-4246

Phone

(520) 219-0178

Fax

(520) 297-2242

NPI assigned

Jul 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Jennifer Jacobson MSN Pmhnp-BC PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tucson, AZ
  • NPI 1861621831
  Medicare reassignment NPD Authorized official
• J&P Loiselle LLC

  • Addiction (Substance Use Disorder) Counselor
  • Tucson, AZ
  • NPI 1073655544
  NPD (past)
• Lafrontera Center Inc

  • Methadone Clinic
  • Tucson, AZ
  • NPI 1548361470
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247356800000",
    "number": "1730114976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6812 N ORACLE RD",
            "address_2": "114",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857044246",
            "telephone_number": "520-219-0178",
            "fax_number": "520-297-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6812 N ORACLE RD",
            "address_2": "114",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857044246",
            "telephone_number": "520-219-0178",
            "fax_number": "520-297-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "JENNIFER",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2009-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CT",
            "license": "003070",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN 106778 AP1265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004251542",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Ann Jacobs, PHARMD
• Suesan Lee Jacobs, PHARM.D.
• Lauren Jacobsen, PA
• Wayne Jacobsen, MD
• Angela Jacobson
• Kody Jacobson
• Marc S Jacobson, MD
• McKenzie Jacobson
• Rachel L Jacobson, PHARMD
• Sandra M Jacobson, RD

• Psychiatric/Mental Health Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.