Russell Steven Jacobus, RT(ARRT)

Primary specialty

Radiography Radiologic TechnologistTaxonomy code 2471C3402X

Practice address

1127 Old Rd
Chapin, SC 29036-8512

Phone

(803) 771-0070

Fax

(803) 781-0077

NPI assigned

Feb 27, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mobile Medical Imaging LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Chapin, SC
  • NPI 1619158862
  NPD (past) Authorized official

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841326287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 OLD RD",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290368512",
            "telephone_number": "803-771-0070",
            "fax_number": "803-781-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 OLD RD",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290368512",
            "telephone_number": "803-771-0070",
            "fax_number": "803-781-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBUS",
        "first_name": "RUSSELL",
        "middle_name": "STEVEN",
        "credential": "RT(ARRT)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498018",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle M Huet, OTR
• Kaitlin Hughes, DPT
• Mary Huth
• Brenda Hyleman, MSW
• Ideal Intervention, LLC
• Angela Slice Jones, MSP, CCC-SLP,BCBA
• Brittany Nicole Jones, FNP-C
• Amy White Joyner, FNP
• Jumpstart Pediatrics LLC
• Amy Louise Kayekjian, OD

• Radiography Radiologic Technologist in Chapin, SC
• Providers in Chapin, SC by specialty
• Radiography Radiologic Technologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.