Jacob Michael Dakota Redfox, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.006018RX Issued in OH

Practice address

7610 Tournament Dr
Waterville, OH 43566-8702

Phone

(419) 704-6634

NPI assigned

Aug 22, 2019

Last updated

Aug 16, 2022By 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

Enrolled in OH

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

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbus Radiology CorpGroup PAC ID 6507754983, 290 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Columbus Radiology Corp

  • Diagnostic Radiology Physician
  • Columbus, OH
  • NPI 1669408159
  Medicare reassignment Care Compare group
• Columbus Radiology Corp

  • Diagnostic Radiology Physician
  • Columbus, OH
  • NPI 1497287197
  NPD
• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Health - St Vincent Medical Center LLC

  dba Mercy Health St Vincent Medical Center

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1467493551
  Care Compare affiliation

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1770130858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 E BROAD ST STE 1400",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432153806",
            "telephone_number": "614-228-7231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7610 TOURNAMENT DR",
            "city": "WATERVILLE",
            "state": "OH",
            "postal_code": "435668702",
            "telephone_number": "419-704-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDFOX",
        "first_name": "JACOB",
        "middle_name": "MICHAEL DAKOTA",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-22",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009468",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006018RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzette M Pelton, RPH
• Dustin Peper, DC
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• Kylie Pocrnich
• Rebel Chiropractic LLC
• Leah Dawn Reichmanis, CCC/SLP
• Rhino31 Inc. (Senior Helpers of NW Ohio)
• R. Daniel Rigal, M.D.
• Daniel J Robinson, O.D.
• James C Robinson, O.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.