Stephanie Susan Jacob, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

61497 Issued in TX

Practice address

2213 Airport Blvd
Austin, TX 78722-1404

Phone

(512) 993-3994

NPI assigned

Sep 14, 2020

Sex

Female

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

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CVS Pharmacy Inc

  • Pharmacy
  • Austin, TX
  • NPI 1235760620
  NPD
• CVS Pharmacy Inc

  • Pharmacy
  • Stafford, TX
  • NPI 1427931351
  NPD (past)

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1972118032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7233 MENCHACA RD UNIT 2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455292",
            "telephone_number": "214-707-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 AIRPORT BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787221404",
            "telephone_number": "512-993-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "STEPHANIE",
        "middle_name": "SUSAN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "61497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Jackson
• Deepa Jacob
• Jennifer Jacob, RBT
• Neil Jacob, MD
• Priya Mary Jacob, MD
• Alyssa Jacobs
• Krista Lynd Jacobs, FNP
• Miranda Jacobs
• Paul C Jacobs, O.D.
• Rachel Lauren Jacobs, LCSW

• All providers in Austin, TX
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.