Daniel Jacobsen, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2016034325 Issued in MO

Practice address

3555 Sunset Office Dr
Ste. C102
Saint Louis, MO 63127-1015

Phone

(314) 262-6755

NPI assigned

Jan 27, 2017

Last updated

Jan 27, 2017By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• SSM Depaul Medical Group, Inc.

  dba DePaul Medical Group at Cross Keys

  • Family Medicine Physician
  • Florissant, MO
  • NPI 1952312951
  NPD (past)

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

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485475200000",
    "number": "1780121830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 SUNSET OFFICE DR",
            "address_2": "STE. C102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271015",
            "telephone_number": "314-262-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 SUNSET OFFICE DR",
            "address_2": "STE. C102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271015",
            "telephone_number": "314-262-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-27",
        "last_updated": "2017-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2016034325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myron H Jacobs, M.D.
• Nathan Richard Jacobs
• Robyn Hayley Jacobs, MD
• Shanda Jacobs, RN, BSN, APN, BC-FNP
• Shawn Jacobs, AA
• Glenn C. Jacobsen, MD
• Kyle G Jacobsen, MD
• Mary Jacobsmeyer, LCSW
• Eric Jacobsohn, MD
• Arnold Scott Jacobson, DMD

• Adult Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.