Active NPI
Timothy G Jacobson
- Driver
- Waterloo, IA
National Provider Identifier
1881484426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 259DD3969
- Practice address
- 701 Lorraine Ave
Waterloo, IA 50702-3959 - Phone
- (319) 239-2955
- NPI assigned
- May 7, 2025
- Last updated
- May 7, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 259DD3969 | IA | Primary |
Addresses
Primary practice location
701 Lorraine Ave
Waterloo, IA 50702-3959
Mailing address
701 Lorraine Ave
Waterloo, IA 50702-3959
Phone (319) 239-2955
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 259DD3969 | IA | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746576000000",
"number": "1881484426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 LORRAINE AVE",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507023959",
"telephone_number": "319-239-2955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 LORRAINE AVE",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507023959",
"telephone_number": "319-239-2955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "TIMOTHY",
"middle_name": "G",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-05-07",
"last_updated": "2025-05-07",
"certification_date": "2025-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "IA",
"license": "259DD3969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.