Active NPI
Alicia Jakobcic
- Other Technician
- Royal Oak, MI
National Provider Identifier
1801262647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- J212048585172
- Practice address
- 4228 S Fulton PL
Royal Oak, MI 48073-6358 - Phone
- (248) 554-0279
- NPI assigned
- Aug 17, 2015
- Last updated
- Aug 17, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Other Technician | 247200000X | J212048585172 | MI | Primary |
Addresses
Primary practice location
4228 S Fulton PL
Royal Oak, MI 48073-6358
Mailing address
4228 South Fulton Place
Royal Oak, MI 48073
Phone (248) 554-0279
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
| License | State | Type | Specialty |
|---|---|---|---|
| J212048585172 | MI | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439769600000",
"number": "1801262647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4228 SOUTH FULTON PLACE",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "48073",
"telephone_number": "248-554-0279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4228 S FULTON PL",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480736358",
"telephone_number": "248-554-0279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAKOBCIC",
"first_name": "ALICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-17",
"last_updated": "2015-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "MI",
"license": "J212048585172",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.