Melissa Jacobsen, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001396 Issued in IA

Practice address

601 Highway 6 W
Medicine (111)
Iowa City, IA 52246-2292

Phone

(319) 338-0581

Fax

(319) 887-4920

NPI assigned

Jul 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740205335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HIGHWAY 6 W",
            "address_2": "MEDICINE (111)",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522462292",
            "telephone_number": "319-338-0581",
            "fax_number": "319-887-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HIGHWAY 6 W",
            "address_2": "MEDICINE (111)",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522462292",
            "telephone_number": "319-338-0581",
            "fax_number": "319-887-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "MELISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "001396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Troy Jackson
• Marisa Jacob-Leonce, MD
• Casey Elizabeth Jacobs, MD
• Dean A Jacobs, CHIROPRACTOR
• Deanna Marie Jacobs, PHARMD
• Michael Jacobsen
• Ryan Blaine Jacobsen, PHARMD
• Annelise Jacobson
• Larkin Jacobson
• Lisa Jacobson

• Medical Physician Assistant in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Medical Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.