Individual provider Active NPI

Brennan Frazier Jacobs

  • Women's Health Nurse Practitioner
  • Washington, DC
National Provider Identifier
1871323667
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
NP1048396 Issued in DC
Practice address
2333 Ontario Rd NW
Washington, DC 20009-2627
Phone
(202) 483-8196
NPI assigned
Aug 6, 2024
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X NP1048396 DC Primary

Addresses

Primary practice location

2333 Ontario Rd NW
Washington, DC 20009-2627

Mailing address

1324 Euclid St NW Apt 101
Washington, DC 20009-4834
Phone (615) 430-6558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250205000599 DC Practitioner - Nurse Practitioner 5496285512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2333 Ontario Rd NW
Washington, DC 20009-2627
Phone (202) 483-8196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary's Center for Maternal and Child Care, Inc Current Accepting new patients
Marys Center for Maternal and Child Care Inc CurrentSince Jan 3, 2025 Accepting new patients
Mary's Center for Maternal and Child Care, Inc CurrentSince Jan 3, 2025 Accepting new patients

Locations

2333 Ontario Rd NW
Washington, DC 20009
Phone (202) 420-7175

3912 Georgia Ave NW
Washington, DC 20011
Phone (844) 796-2797

6315 5th St NW
Washington, DC 20011
Phone (202) 671-6080

100 Gallatin St NE
Washington, DC 20011
Phone (202) 545-0515

8908 Riggs Rd
Hyattsville, MD 20783
Phone (301) 408-6860

344 University Blvd W
Silver Spring, MD 20901
Phone (301) 439-0300

Interoperability endpoints

  • Direct secure messaging: brennan.jacobs@maryscenter.eclinicaldirectplus.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1871323667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 EUCLID ST NW APT 101",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200094834",
            "telephone_number": "615-430-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 ONTARIO RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092627",
            "telephone_number": "202-483-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "BRENNAN",
        "middle_name": "FRAZIER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "DC",
            "license": "NP1048396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.