Ian Terrell Jacobs, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

324906 Issued in NY

Practice address

4 Granada Cres Apt 19
White Plains, NY 10603-1237

Phone

(718) 431-5167

NPI assigned

May 9, 2019

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1912562448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GRANADA CRES APT 19",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106031237",
            "telephone_number": "718-431-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GRANADA CRES APT 19",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106031237",
            "telephone_number": "718-431-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "IAN",
        "middle_name": "TERRELL",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-09",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "324906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Wilma Jackson, D.D.S.
• Shemel Jackson
• Christine Jacob
• Maryann Prakash Jacob, M.D.
• Noble Jacob
• Melissa Jacobs
• Stephanie Jacobs, LMHC, PH.D.
• Susan Jacobson-Mayer, NP
• William Jacobson, MD
• Maria Esther Jacome, D.D.S.

• Licensed Practical Nurse in White Plains, NY
• Providers in White Plains, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.