Traci Jacobs, PHARM.D

Primary specialty

PharmacistTaxonomy code 183500000X

License

15444 Issued in NC

Practice address

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Phone

(336) 718-5749

NPI assigned

Jan 19, 2021

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1932799459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 CREEKSHIRE WAY APT 111",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033086",
            "telephone_number": "828-217-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-718-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "TRACI",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "15444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BOARD OF PHARMACY",
            "identifier": "15444",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgjacobs@novanthealth.org",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "3333 Silas Creek Pkwy",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271033013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacob Brotzman DMD PLLC
• Jose Guadalupe Jacobo Pacheco
• Garcia Jacobs Harris
• Bradley Edgar Jacobs, MD
• Kimura Garcia Chermez'S Jacobs, PA-C
• Mary E Jacobsen, PSY.D.
• Leslie Sue Jacobson, MD
• Darius A. Jahann, M.D.
• Jai Siddhi Vinayak Inc.
• Jai Siddhi Vinayak Inc.

• Pharmacist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Pharmacist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.