James R Jacobs, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C4111 Issued in AR

Practice address

411 Falls Blvd S
Wynne, AR 72396-3501

Phone

(870) 238-3261

Fax

(870) 238-3115

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1972658771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 FALLS BLVD S",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963501",
            "telephone_number": "870-238-3261",
            "fax_number": "870-238-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 FALLS BLVD S",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963501",
            "telephone_number": "870-238-3261",
            "fax_number": "870-238-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JAMES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C4111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102032001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Hylle
• Amy E. Jackson, PT, DPT
• Julia Rebecca Meyer Jackson, O.D.
• Neall Clark Jackson, D.D.S.
• Jacob Sutton, DDS, PA
• Jherica James
• Alexandria Gaines Jarrett, MCD, CF-SLP
• Natalie Jarrett
• Merideth L Johnson, LCSW
• Sara Johnson

• Family Medicine Physician in Wynne, AR
• Providers in Wynne, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.