Active NPI
Leah Jacobs, NP-C
- Family Nurse Practitioner
- Stockbridge, GA
National Provider Identifier
1942728449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN209956
- Practice address
- 5095 Mount Zion Pkwy
Stockbridge, GA 30281-7825 - Phone
- (770) 507-0576
- NPI assigned
- Sep 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | RN209956 | GA | |
| Family Nurse Practitioner | 363LF0000X | RN209956 | GA | Primary |
Addresses
Primary practice location
5095 Mount Zion Pkwy
Stockbridge, GA 30281-7825
Mailing address
5095 Mount Zion Pkwy
Stockbridge, GA 30281-7825
Other practice location 1
2759 Mount Zion Pkwy
Jonesboro, GA 30236-2568
Phone (770) 603-0533
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN209965 | Other | STATE LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | None |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN209956 | GA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575072000000",
"number": "1942728449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5095 MOUNT ZION PKWY",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302817825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5095 MOUNT ZION PKWY",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302817825",
"telephone_number": "770-507-0576"
}
],
"practiceLocations": [
{
"address_1": "2759 Mount Zion Pkwy",
"address_purpose": "LOCATION",
"city": "Jonesboro",
"state": "GA",
"postal_code": "302362568",
"country_code": "US",
"telephone_number": "770-603-0533",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBS",
"first_name": "LEAH",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-05",
"last_updated": "2019-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "RN209956",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN209956",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "RN209965",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "None",
"affiliation": "N",
"address_1": "5095 Mount Zion Pkwy",
"city": "Stockbridge",
"state": "GA",
"country_code": "US",
"postal_code": "302817825",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Stockbridge, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.