Angela T Jacobs, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10858517-4405 Issued in UT

Practice address

668 E 12225 S Ste 204
Draper, UT 84020-8385

Phone

(801) 899-6220

NPI assigned

Jul 31, 2023

Sex

Female

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Pioneer Injury Care

  • Nurse Practitioner
  • Draper, UT
  • NPI 1114382033
  NPD (past)

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1881375962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 E 12225 S STE 204",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208385",
            "telephone_number": "801-899-6220",
            "fax_number": "855-402-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 E 12225 S STE 204",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208385",
            "telephone_number": "801-899-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "ANGELA",
        "middle_name": "T",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "UT",
            "license": "10858517-3102",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "10858517-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Jackman
• Makala Jackson-Clinton
• Amelia Jackson, M.S., SLP-CCC
• Devin S Jackson, PHARMD
• Kennedy Garland Jackson
• Kristy Jager
• Sophia Jaimes
• Natalie James
• Dean E Jarman, DDS
• Jenna Jarrell

• Family Nurse Practitioner in Draper, UT
• Providers in Draper, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.