DR. ANGELA RENEE JACOB (NPI# 1124430806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124430806 |
| Entity Type | Individual |
| Full Name | DR. ANGELA RENEE JACOB |
| Credential | D.P.M. |
| Practice Address |
422 N Center St Suite B Northville MI 48167 |
| Mailing Address |
422 N Center St Suite B Northville MI 48167-1224 |
| Practice Telephone | 2484497156 |
| Mailing Telephone | 2484497156 |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2018-05-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
5315080074 | MI | Podiatric Medicine & Surgery Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023431756 | Angela Marie Jacob | Physician Assistant | 3333 Burnet Ave, Ml 2017, Cincinnati, OH 45229 | 2014-01-31 |
| Street Address |
422 N CENTER ST SUITE B |
| City | NORTHVILLE |
| State | MI |
| Zip Code | 48167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477551893 | Alan J. Bloch | Podiatrist | 422 N Center St, Suite B, Northville, MI 48167-1224 | 2005-07-09 |
| 1669974556 | Jennifer Marie Gardner | Social Worker | 422 N Center St, Northville, MI 48167-1224 | 2018-03-06 |
| 1871877688 | Pamela A Gumkowski | Dietitian, Registered | 422 N Center St, Northville, MI 48167-1224 | 2011-09-29 |
| 1275812844 | Family Medicine Obstetrics of Northville | Obstetrics & Gynecology | 422 N Center St, Northville, MI 48167-1224 | 2011-08-12 |
| 1821391848 | Envision Medical Group Pllc | Family Medicine | 422 N Center St, Northville, MI 48167-1224 | 2010-12-14 |
| 1821309097 | Christopher L Mcgrew | Physician Assistant | 422 N Center St, Northville, MI 48167-1224 | 2010-06-23 |
| 1235456609 | Envision Medical Group Pllc | Family Medicine | 422 N Center St, Suite B, Northville, MI 48167-1224 | 2010-04-26 |
| 1639392780 | Alan J. Bloch Dpm, Pllc | Podiatrist | 422 N Center St, Suite B, Northville, MI 48167-1224 | 2007-04-10 |
| 1376679399 | Marsha Billes | Family Medicine | 422 N Center St, Northville, MI 48167-1224 | 2007-02-26 |
| 1427194927 | Main Street Family Medicine P C | Family Medicine | 422 N Center St, Northville, MI 48167-1224 | 2007-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093277873 | Kathleen Mary Vollman | Nursing Care | 21091 Boulder Cir, Northville, MI 48167 | 2019-04-02 |
| 1851877211 | Saleh Medical Innovations Consulting Plc | Clinic/Center | 9308 Hickory Ridge Road, Northville, MI 48167 | 2018-07-18 |
| 1811488877 | Carrie Millis Babe | Marriage & Family Therapist | 23095 Kirkland Ct, Northville, MI 48167 | 2018-05-25 |
| 1134671761 | Richard Roff | Technician, Other | 3253 Lancaster Ln, Northville, MI 48167 | 2016-10-31 |
| 1508241613 | Naastar Enterprises, LLC | Non-emergency Medical Transport (VAN) | 20871 W. Glen Haven Circle, Novi, MI 48167 | 2015-07-30 |
| 1396159083 | Traci L Rasor | Registered Nurse | 143 Cadycentre Unit 250, Northville, MI 48167 | 2014-06-20 |
| 1932459930 | Amanda Lea Williams | Nurse Practitioner | 44300 Five Mile Rd, Northville Twp, MI 48167 | 2012-09-17 |
| 1346505914 | Richard Thomas Mac Laren | Emergency Medicine | 51920 8 Mile Road, Northville, MI 48167 | 2012-07-10 |
| 1053647818 | Mark S. Hunter, D.m.d. P.l.c. | Dentist | 149 N. Center, Suite 101, Northville, MI 48167 | 2009-10-28 |
| 1437384088 | Maria Conley | Dietitian, Registered | 40000 West 8 Mile Rd, Northville, MI 48167 | 2009-05-27 |
| Find all providers in zip 48167 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609121185 | Andrew Aram Mechigian | Podiatrist | 42925 7 Mile Rd, Northville, MI 48167-2277 | 2012-07-19 |
| 1619165412 | Alex West | Podiatrist | 48240 Manorwood Dr, Northville, MI 48168-8480 | 2007-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056665 | Radu Purtuc Dpm Pllc | Podiatrist | 20005 Hidden Oaks Dr, Brownstown, MI 48183-3276 | 2020-09-03 |
| 1790300978 | Bhavik Patel | Podiatrist | 16001 W 9 Mile Rd Fl 2, Southfield, MI 48075-4818 | 2020-06-12 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1770104580 | Ali Chami | Podiatrist | 20115 River Oaks Dr, Dearborn Heights, MI 48127-2709 | 2020-05-04 |
| 1780233627 | Bloomfield Foot & Ankle Specialists Pllc | Podiatrist | 43750 Woodward Ave Ste 102, Bloomfield Hills, MI 48302-5063 | 2019-09-04 |
| 1063068435 | Monaghan Post-vasold Podiatry Plc | Podiatrist | 5377 N Waldo Rd, Midland, MI 48642-9713 | 2019-08-12 |
| 1598323909 | Lakeside Foot & Leg Care Pllc | Podiatrist | 14322 Grandview Dr, Sterling Heights, MI 48313-3447 | 2019-05-31 |
| 1285297481 | J Weber Medical Group Pllc | Podiatrist | 620 Woodmere Ave Ste C, Traverse City, MI 49686-3397 | 2019-04-15 |
| 1093219743 | Holland Community Hospital | Podiatrist | 3299 N Wellness Dr Ste 230, Holland, MI 49424-7271 | 2018-03-19 |
| 1780182907 | Jeffrey Schwalb Dpm Pllc | Podiatrist | 5755 W Maple Rd Ste 115, W Bloomfield, MI 48322-4415 | 2018-01-23 |
| Find all providers with the same taxonomy | ||||
| City | NORTHVILLE |
| Zip Code | 48167 |
Please comment or provide details below to improve the information on DR. ANGELA RENEE JACOB.
| 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.