Active NPI
Kurt Leon Jacobs, DO
- Family Medicine Physician
- Rushville, IN
National Provider Identifier
1891755286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 990020099A
- Practice address
- 807 S St Rd 3
Rushville, IN 46173 - Phone
- (765) 933-1371
- NPI assigned
- Mar 28, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 990020099A | IN | Primary |
Addresses
Primary practice location
807 S St Rd 3
Rushville, IN 46173
Mailing address
1941 Virginia Ave
Connersville, IN 47331
Phone (765) 827-7700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2073689 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 990020099A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fayette Memorial Hospital Association Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Connersville, IN
- NPI 1508825720
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328140800000",
"number": "1891755286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1941 VIRGINIA AVE",
"city": "CONNERSVILLE",
"state": "IN",
"postal_code": "47331",
"telephone_number": "765-827-7700",
"fax_number": "765-827-7796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 S ST RD 3",
"city": "RUSHVILLE",
"state": "IN",
"postal_code": "46173",
"telephone_number": "765-933-1371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "KURT",
"middle_name": "LEON",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-28",
"last_updated": "2012-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "990020099A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2073689",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rushville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.