David Jacobson Jr., PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50000362 Issued in OH

Practice address

36000 Euclid Ave
Willoughby, OH 44094

Phone

(440) 953-6203

Fax

(440) 953-6202

NPI assigned

Mar 30, 2006

Last updated

Nov 15, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Anesthesia Associates, PLL

  • Specialist
  • Painesville, OH
  • NPI 1801823182
  NPD (past)
• Emergency Professionals of Ohio, Inc.

  • Nurse Practitioner
  • Athens, OH
  • NPI 1750313854

  Physician Assistant

  NPD (past)
• Lake Emergency Services Inc

  • Emergency Medicine Physician
  • Willoughby, OH
  • NPI 1518927995
  NPD (past)
• Trumbull Emergency Group PC, Inc

  • Emergency Medicine Physician
  • Warren, OH
  • NPI 1750749719

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1760443659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7381 WILLOW RUN DR",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440603529",
            "telephone_number": "440-413-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 EUCLID AVE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "44094",
            "telephone_number": "440-953-6203",
            "fax_number": "440-953-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "DAVID",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022384-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50000362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Anstandig, M.D., Inc.
• Kim Yvette Jackson, LPN
• Latoiya Talisha Jackson, LPN
• Traci Jackson
• Bruce Robert Jacobson, M.D.
• Neil A Jacobson, MD
• Jamal Azem, M.D., Inc
• James C. Trouten, D.D.S., M.S., Inc.
• Christopher Campbell James, D.O
• Dillon J James

• Physician Assistant in Willoughby, OH
• Providers in Willoughby, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.