Active NPI
Jacob Tyler Patrick
- Internal Medicine Physician
- Grand Junction, CO
National Provider Identifier
1821522822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- DR.0076765
- Practice address
- 607 28 1/4 Rd
Grand Junction, CO 81506-6018 - Phone
- (970) 243-3300
- Fax
- (970) 243-4464
- NPI assigned
- Apr 17, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | DR.0076765 | CO | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
607 28 1/4 Rd
Grand Junction, CO 81506-6018
Mailing address
PO Box 1727
Grand Junction, CO 81502-1727
Phone (970) 257-6200
Other practice location 1
17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Phone (813) 974-2201
Other practice location 2
500 South Preston Street
Room 305
Louisville, KY 40202
Phone (502) 852-8696
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785715200000",
"number": "1821522822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1727",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815021727",
"telephone_number": "970-257-6200",
"fax_number": "970-263-2691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 28 1/4 RD",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815066018",
"telephone_number": "970-243-3300",
"fax_number": "970-243-4464"
}
],
"practiceLocations": [
{
"address_1": "17 Davis Blvd Ste 308",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336063438",
"country_code": "US",
"telephone_number": "813-974-2201",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "500 South Preston Street",
"address_2": "Room 305",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "40202",
"country_code": "US",
"telephone_number": "502-852-8696",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATRICK",
"first_name": "JACOB",
"middle_name": "TYLER",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-17",
"last_updated": "2026-08-03",
"certification_date": "2026-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "DR.0076765",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Junction, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.