DR. RICHARD DAVID JACOBSON (NPI# 1013968858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013968858 |
| Entity Type | Individual |
| Full Name | DR. RICHARD DAVID JACOBSON |
| Credential | MD, PHD |
| Practice Address |
4228 Brookfield Dr Charlotte NC 28210 |
| Mailing Address |
3 Maryland Farms Ste 200 Brentwood TN 37027-5005 |
| Practice Telephone | 6153455400 |
| Mailing Telephone | 6153455400 |
| Mailing Fax Number | 8884686603 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-10-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
ME127847 | FL | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
31216 | WI | Allopathic & Osteopathic Physicians |
| N | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
ME127847 | FL | Allopathic & Osteopathic Physicians |
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
01389 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | STATE LICENSE | ME127847 | 01 |
| NC | 5915702 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952443673 | Richard Samuel Jacobson | Pediatrics | 10515 Balboa Bl., Suite 250, Granada Hills, CA 91344 | 2007-02-12 |
| 1053399691 | Richard Y Jacobson | Optometrist | 1428 2nd Ave N, Medical Arts Bldg, Fort Dodge, IA 50501-4119 | 2006-01-04 |
| 1114411824 | Richard Michael Jacobson | Counselor | 401 W Morrison Ave Ste B, Santa Maria, CA 93458-6124 | 2018-06-15 |
| 1144601667 | Richard A Jacobson Jr. | Surgery | 1653 W Congress Pkwy, Chicago, IL 60612-3833 | 2015-06-10 |
| 1063614477 | Richard Harvey Jacobson | Psychiatry & Neurology | 1100 Ward Ave, Suite 1070, Honolulu, HI 96814-1600 | 2007-06-05 |
| 1184751125 | Richard Leslie Jacobson | Dentist | 881 Alma Real Dr, Suite 200, Pacific Palisades, CA 90272-3731 | 2007-02-27 |
| 1750391280 | Richard G Jacobson | Physician Assistant | 101 Saint Andrews Ln, Glen Cove, NY 11542-2254 | 2006-08-08 |
| 1023042686 | Richard Yngve Jacobson Jr. | Nurse Anesthetist, Certified Registered | 112 Jefferson St, West Union, IA 52175 | 2006-07-10 |
| 1477500288 | Richard Wesley Jacobson | Emergency Medicine | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2006-05-27 |
| Street Address |
4228 BROOKFIELD DR |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952920860 | Rx Care 14 LLC | Pharmacy | 7701 Sharon Lakes Road, Suite H, Charlotte, NC 28210 | 2020-04-10 |
| 1427697622 | David Durant Dinsmore | Nurse Anesthetist, Certified Registered | Atrium Health Pineville, 10628 Park Road, Charlotte, NC 28210 | 2020-01-06 |
| 1790256964 | Tele Phys Inc | Internal Medicine | 10035 Park Center Dr., Ste 100, Charlotte, NC 28210 | 2018-12-16 |
| 1104395896 | Bridgett Williams | Behavior Technician | 7806 Andover Woods Drive, Charlotte, NC 28210 | 2018-11-26 |
| 1053880518 | Low-t Physicians Professional Association | Internal Medicine | 10430 Park Road Suite 100a, Charlotte, NC 28210 | 2018-11-14 |
| 1053895102 | Carolinas Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 7701 Sharon Lakes Blvd, Ste A., Charlotte, NC 28210 | 2018-09-24 |
| 1679066658 | Afc Urgent Care and Family Care of Wnc, Pllc | Clinic/Center | 10102 Johnston Rd, Charlotte, NC 28210 | 2018-06-13 |
| 1346777018 | Hopeway Foundation | Clinic/Center | 1717 Sharon Road West, Charlotte, NC 28210 | 2017-05-12 |
| 1891154688 | Jessie Lee Ogienko | Social Worker | 5960 Fairview Rd Ste 328, Charlotte, NC 28210 | 2016-02-22 |
| 1699151985 | Carolina Complete Psychiatry, Pllc | Physician Assistant | 5950 Fairview Road, Suite 708, Charlotte, NC 28210 | 2015-08-10 |
| Find all providers in zip 28210 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033675079 | Novant Medical Group Inc | Psychiatry & Neurology | 1918 Randolph Rd Ste 320, Charlotte, NC 28207-1109 | 2019-02-14 |
| 1023415981 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 12311 Copper Way, Suite 200-a, Charlotte, NC 28277-3642 | 2014-11-20 |
| 1073932885 | Neurology Wellness, Pllc | Psychiatry & Neurology | 10508 Park Rd, Ste 130, Charlotte, NC 28210-8525 | 2014-04-09 |
| 1780011825 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 2608 E 7th St, Charlotte, NC 28204-4375 | 2013-10-03 |
| 1518394659 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 101 E W T Harris Blvd, Bldg 3000 Ste 3301b, Charlotte, NC 28262-3485 | 2013-10-03 |
| 1720415946 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 1001 Blythe Blvd, Ste 200, Charlotte, NC 28203-5866 | 2013-10-02 |
| 1922367077 | Carolinas Medical Center-northeast | Psychiatry & Neurology | 4501 Cameron Valley Pkwy, Suite 301-a, Charlotte, NC 28211-4297 | 2012-05-10 |
| 1699060384 | Carolinas Medical Center-northeast | Psychiatry & Neurology | 101 E W T Harris Blvd, Bldg 3000, Suite 3301b, Charlotte, NC 28262-7000 | 2011-06-10 |
| 1972806321 | Cmc-northeast, Inc. | Psychiatry & Neurology | 1001 Blythe Blvd, Suite 200 Cpnc - Charlotte Specialty Center, Charlotte, NC 28203-5866 | 2010-12-07 |
| 1265747497 | Cmc-northeast, Inc. | Psychiatry & Neurology | 1010 Edgehill Rd N, Carolinas Pediatric Neurology Care - Charlotte, Charlotte, NC 28207-1885 | 2010-08-12 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.