Individual provider Active NPI

Elizabeth Jacobson, CRNFA

  • Registered Nurse First Assistant
  • Saint Paul, MN
National Provider Identifier
1760572580
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
R0839349 Issued in MN
Practice address
17 W Exchange St
622 Metropolitan OB and GYN
St Paul, MN 55102
Phone
(651) 227-9141
Fax
(651) 265-6772
NPI assigned
Oct 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X R0839349 MN Primary

Addresses

Primary practice location

17 W Exchange St
622 Metropolitan OB and GYN
St Paul, MN 55102

Mailing address

17 W Exchange St
622 Metropolitan Obstetrics and Gynecology PA
St Paul, MN 55102
Phone (651) 227-9141

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R0839349MNMDRegistered Nurse First Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Obstetrics & Gynecology Past Accepting new patients
Premier OBGYN of Minnesota PLLC PastSince Apr 1, 2011 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760572580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 W EXCHANGE ST",
            "address_2": "622 METROPOLITAN OBSTETRICS AND GYNECOLOGY PA",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55102",
            "telephone_number": "651-227-9141",
            "fax_number": "651-265-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W EXCHANGE ST",
            "address_2": "622 METROPOLITAN OB AND GYN",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55102",
            "telephone_number": "651-227-9141",
            "fax_number": "651-265-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ELIZABETH",
        "credential": "CRNFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "MN",
            "license": "R0839349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.