Active NPI
Julie Ann Jacobs, P.A.
- Physician Assistant
- Saint Joseph, MI
National Provider Identifier
1770592008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 004737
- Practice address
- 1234 Napier Ave
Saint Joseph, MI 49085-2112 - Phone
- (269) 983-3800
- NPI assigned
- Aug 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004737 | MI | Primary |
Addresses
Primary practice location
1234 Napier Ave
Saint Joseph, MI 49085-2112
Mailing address
17290 Maplehurst Run
Granger, IN 46530-9082
Phone (574) 273-9685
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004737 | MI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770592008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17290 MAPLEHURST RUN",
"city": "GRANGER",
"state": "IN",
"postal_code": "465309082",
"telephone_number": "574-273-9685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1234 NAPIER AVE",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490852112",
"telephone_number": "269-983-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "JULIE",
"middle_name": "ANN",
"credential": "P.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "004737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Joseph, MI
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.