Glenn C. Jacobsen, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2005007371 Issued in MO

Practice address

7 Carrswold Dr
Saint Louis, MO 63105-2914

Phone

(314) 300-8265

NPI assigned

Jan 4, 2020

Last updated

Jan 4, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1578096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578096000000",
    "number": "1780223933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARRSWOLD DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631052914",
            "telephone_number": "314-300-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CARRSWOLD DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631052914",
            "telephone_number": "314-300-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "GLENN",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-04",
        "last_updated": "2020-01-04",
        "certification_date": "2020-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2005007371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Richard Jacobs
• Robyn Hayley Jacobs, MD
• Shanda Jacobs, RN, BSN, APN, BC-FNP
• Shawn Jacobs, AA
• Daniel Jacobsen, ANP
• Kyle G Jacobsen, MD
• Mary Jacobsmeyer, LCSW
• Eric Jacobsohn, MD
• Arnold Scott Jacobson, DMD
• Brittany Jacobson, PH.D.

• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2020; 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.