Thomas C Jacobus, LAT, ATC, EMT-B

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

558323 Issued in NJ

Practice address

26 3Rd Ave # 1
Little Falls, NJ 07424-1520

Phone

(973) 818-9325

NPI assigned

Dec 6, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1811764236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 3RD AVE # 1",
            "city": "LITTLE FALLS",
            "state": "NJ",
            "postal_code": "074241520",
            "telephone_number": "973-818-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 3RD AVE # 1",
            "city": "LITTLE FALLS",
            "state": "NJ",
            "postal_code": "074241520",
            "telephone_number": "973-818-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBUS",
        "first_name": "THOMAS",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "LAT, ATC, EMT-B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-06",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00155100",
            "primary": false
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NJ",
            "license": "558323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Basic Emergency Medical Technician in Little Falls, NJ
• Providers in Little Falls, NJ by specialty
• Basic Emergency Medical Technician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.