Nicole Jacobs, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RNP248636 Issued in AZ

Practice address

2100 Centerpointe West Dr
Prescott, AZ 86301-8487

Phone

(928) 717-0788

Fax

(928) 717-0748

NPI assigned

Aug 10, 2022

Last updated

Aug 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Eric Baumann MD, PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Prescott, AZ
  • NPI 1588620421
  Medicare reassignment NPD

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1902534688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CENTERPOINTE WEST DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863018487",
            "telephone_number": "928-717-0788",
            "fax_number": "928-717-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CENTERPOINTE WEST DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863018487",
            "telephone_number": "928-717-0788",
            "fax_number": "928-717-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RNP248636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J&G Medical Services PLLC
• Karolyn S Jackson, PA-C
• Rose M Jackson, RRT
• Lourdes R Jacobo, M.D.
• Autum Renee Jacobs, FNP-BC
• Jeffrey Jacques, D.O.
• James Leo, M.D., PLLC
• James Marco Health LLC (Whitney James MD PC)
• Dale William James, RPH, PHD
• Trenton James, ATC

• Family Nurse Practitioner in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.