Individual provider Active NPI

Joseph Elmer Jacobson, MD

  • Orthopaedic Foot and Ankle Surgery Physician
  • Salisbury, NC
National Provider Identifier
1982051280
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
2022-00307 Issued in NC
Practice address
810 Mitchell Ave
Salisbury, NC 28144-6253
Phone
(704) 216-5633
Fax
(704) 639-0785
NPI assigned
May 17, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 11018692 IN
Orthopaedic Surgery Physician 207X00000X 2022-00307 NC
Orthopaedic Surgery Physician 207X00000X 87991 GA
Student in an Organized Health Care Education/Training Program 390200000X 11018692A IN
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 2022-00307 NC Primary

Addresses

Primary practice location

810 Mitchell Ave
Salisbury, NC 28144-6253

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 216-5633

Other practice location 1

1120 W Michigan St
Suite 600
Indianapolis, IN 46202-5209
Phone (317) 278-5835

Other names 1

  • Joseph Elmer Jacobson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220909002108 NC Practitioner - Orthopedic Surgery 9032401096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

810 Mitchell Ave
Salisbury, NC 28144-6253
Phone (704) 216-5633

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)13
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11018692INMDOrthopaedic Surgery Physician
2022-00307NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Orthopaedic Surgery CurrentSince Aug 1, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 1, 2022 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

4741 Randolph Rd
#100
Charlotte, NC 28211
Phone (704) 365-6730

1910 Jake Alexander Blvd W
Ste 202
Salisbury, NC 28147
Phone (704) 216-5633

810 Mitchell Ave
Salisbury, NC 28144
Phone (704) 216-2633

1035 Lincolnton Rd
Ste F
Salisbury, NC 28144
Phone (704) 216-5633

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: jjacobson42672@direct.emory.org
  • Direct secure messaging: jjacobson1055587@direct.novanthealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1982051280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-216-5633",
            "fax_number": "704-639-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 MITCHELL AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281446253",
            "telephone_number": "704-216-5633",
            "fax_number": "704-639-0785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 W Michigan St",
            "address_2": "Suite 600",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025209",
            "country_code": "US",
            "telephone_number": "317-278-5835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "JOSEPH",
        "middle_name": "ELMER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-17",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "11018692",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2022-00307",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "87991",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11018692A",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "NC",
            "license": "2022-00307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSEPH",
            "last_name": "JACOBSON",
            "middle_name": "ELMER",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.