Active NPI
Scott Dominick Jacobs Jr.
- Athletic Trainer
- New Orleans, LA
National Provider Identifier
1952086639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 337148
- Practice address
- 200 Henry Clay Ave
New Orleans, LA 70118-5720 - Phone
- (985) 507-0273
- NPI assigned
- Jun 20, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 337148 | LA | Primary |
Addresses
Primary practice location
200 Henry Clay Ave
New Orleans, LA 70118-5720
Mailing address
285 E McClellan St
Ponchatoula, LA 70454-2843
Phone (985) 507-0273
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 337148 | LA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687219200000",
"number": "1952086639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "285 E MCCLELLAN ST",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "704542843",
"telephone_number": "985-507-0273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HENRY CLAY AVE",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701185720",
"telephone_number": "985-507-0273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "SCOTT",
"middle_name": "DOMINICK",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-20",
"last_updated": "2023-06-20",
"certification_date": "2023-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "LA",
"license": "337148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.