Individual provider Active NPI

Gail A Jacoby, MD

  • Pediatrics Physician
  • Nottingham, MD
National Provider Identifier
1972558245
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0095933 Issued in MD
Practice address
4924 Campbell Blvd
Nottingham, MD 21236-5908
Phone
(443) 442-2300
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD19367 OR
Pediatrics Physician 208000000X D0095933 MD Primary

Addresses

Primary practice location

4924 Campbell Blvd
Nottingham, MD 21236-5908

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (503) 215-6494

Other practice location 1

9427 SW Barnes Rd
Suite 396
Portland, OR 97225-6652
Phone (503) 216-6550

Other identifiers 1

IdentifierTypeStateIssuer
074880MedicaidOR

Other names 1

  • Gail Ann Jacoby-Low Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gjacoby102374@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230802002050 MD Practitioner - Pediatric Medicine 9830103910 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0095933MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians CurrentSince Jun 1, 2023 Accepting new patients
Johns Hopkins Community Physicians, Inc Pediatrics Current Accepting new patients
Johns Hopkins Community Physicians, Inc CurrentSince Jun 1, 2023 Accepting new patients

Locations

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

4924 Campbell Blvd
Nottingham, MD 21236
Phone (443) 442-2200

Interoperability endpoints

  • Direct secure messaging: gjacoby102374@oc.providencedirect.org
  • Direct secure messaging: gjacoby1124579@direct.hopkinsmedicine.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1972558245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4924 CAMPBELL BLVD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212365908",
            "telephone_number": "443-442-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9427 SW Barnes Rd",
            "address_2": "Suite 396",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972256652",
            "country_code": "US",
            "telephone_number": "503-216-6550",
            "fax_number": "503-216-6575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "GAIL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD19367",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0095933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "074880",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gjacoby102374@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9427 SW Barnes Rd Ste 395",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GAIL",
            "last_name": "JACOBY-LOW",
            "middle_name": "ANN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nottingham, MD

Sources for this page

Verify at the official NPI Registry.