Jeanette Marie Jacobs, APRN

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

3012495 Issued in KY

Practice address

901 Wallace Ave
Leitchfield, KY 42754

Phone

(270) 259-5641

Fax

(270) 259-5309

NPI assigned

Aug 10, 2018

Last updated

May 1, 2019By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61385
• Direct secure messaging: jeannette.jacobs@pediatricclinic.directbygreenway.com

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.

• Leitchfield Pediatric Clinic P.S.C.

  • Rural Health Clinic/Center
  • Leitchfield, KY
  • NPI 1558318543

  Pediatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1912486887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WALLACE AVE",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427541417",
            "telephone_number": "270-259-5641",
            "fax_number": "270-259-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WALLACE AVE",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "42754",
            "telephone_number": "270-259-5641",
            "fax_number": "270-259-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JEANETTE",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3012495",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "3012495",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "3012495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica L. Hughes, OTR/L
• Richelle Lynn Humphrey
• Laura Hunt, APRN
• Stephanie Rachelle Hyberger, LPA
• Lydia Jackson, RBT
• Jarboe Family Practice, PSC
• Allyson D Jarboe
• Charles D Jarboe, MD
• Andrew William Jenkins, M.D.
• Cari Beth Johnson, APRN, FNP-BC

• Pediatrics Physician in Leitchfield, KY
• Providers in Leitchfield, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.