Active NPI
Josef Beethoven Jacobson, D.P.T.
- Physical Therapist
- North Augusta, SC
National Provider Identifier
1750322400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4792
- Practice address
- 350 Austin Graybill Rd
North Augusta, SC 29860-9251 - Phone
- (803) 278-4272
- Fax
- (803) 278-1794
- NPI assigned
- Jun 10, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4792 | SC | Primary |
Addresses
Primary practice location
350 Austin Graybill Rd
North Augusta, SC 29860-9251
Mailing address
350 Austin Graybill Rd
North Augusta, SC 29860-9251
Phone (803) 278-4272
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TH1627 | Medicaid | SC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4792 | SC | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aiken Integrated Medical, PC | Physical Therapist | Past | Accepting new patients |
| Strong Health Chiropractic LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Neurology Chiropractor
- Aiken, SC
- NPI 1184818593
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1750322400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 AUSTIN GRAYBILL RD",
"city": "NORTH AUGUSTA",
"state": "SC",
"postal_code": "298609251",
"telephone_number": "803-278-4272",
"fax_number": "803-278-1794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 AUSTIN GRAYBILL RD",
"city": "NORTH AUGUSTA",
"state": "SC",
"postal_code": "298609251",
"telephone_number": "803-278-4272",
"fax_number": "803-278-1794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "JOSEF",
"middle_name": "BEETHOVEN",
"name_prefix": "Mr.",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-10",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "4792",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "TH1627",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Augusta, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.