MARK JACOBS (NPI# 1346359866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346359866 |
| Entity Type | Individual |
| Full Name | MARK JACOBS |
| Credential | PA |
| Practice Address |
833 Princeton Ave Sw Ste 200a Birmingham AL 35211-1321 |
| Mailing Address |
Po Box 909 Louisville KY 40201-0909 |
| Practice Telephone | 2057862776 |
| Mailing Telephone | 5025880328 |
| Mailing Fax Number | 5025880326 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-02-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA.1502 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 15-01583 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE PA LICENSE | PA12419 | 01 |
| NCCPA | 1017889 | 01 | |
| KY | 9500618500 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 201 Abraham Flexner Way Ste 1200, Louisville, KY 402023841 | 5025887600 | 5025887700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598101289 | Mark Jacobs | Pharmacist | 736 Elm, Winnetka, IL 60093-2506 | 2013-05-21 |
| 1497889570 | Mark L Jacobs | Chiropractor | 24825 Northern Blvd, Little Neck, NY 11362-1280 | 2007-03-14 |
| 1346311560 | Mark S Jacobs | Dentist | 802 N Broadway, Melrose Park, IL 60160-3726 | 2006-11-10 |
| 1598770273 | Mark J Jacobs | Dentist | 16824 Newburgh Rd, Livonia, MI 48154-1600 | 2006-07-30 |
| 1457392466 | Mark Edward Jacobs | Optometrist | 507 Greenville Blvd Se, Greenville, NC 27858-6756 | 2006-06-09 |
| 1679533186 | Mark Matthew Jacobs | Obstetrics & Gynecology | 3553 Whipple Road, San Leandro, CA 94587-1507 | 2006-03-27 |
| 1487638409 | Mark I Jacobs | Internal Medicine | 73 Corporate Dr Ste 101, Portsmouth, NH 03801-2847 | 2005-12-02 |
| 1124013883 | Mark D. Jacobs | Internal Medicine | 100 2nd Ave, Needham, MA 02494-2809 | 2005-09-19 |
| 1295737617 | Mark Steven Jacobs | Psychiatry & Neurology | 4888 Loop Central Dr, Suite 510, Houston, TX 77081-2214 | 2005-08-15 |
| 1124023809 | Mark A Jacobs | Optometrist | 3810 S Highway 27, Suite 1, Somerset, KY 42501-3073 | 2005-06-17 |
| Street Address |
833 PRINCETON AVE SW STE 200A |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35211-1321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588651277 | Hugh Timothy Mcconnell | Physician Assistant | 833 Princeton Ave Sw Ste 200a, Birmingham, AL 35211-1321 | 2005-09-29 |
| 1235752841 | Julia Perkins | Nurse Practitioner | 833 Princeton Ave Sw Ste 200a, Birmingham, AL 35211-1321 | 2020-05-19 |
| 1760022875 | Alyssa Morgan Bray | Nurse Practitioner | 833 Princeton Ave Sw Ste 200a, Birmingham, AL 35211-1321 | 2020-01-07 |
| 1124580584 | Jessica Nicole Horsley | Nurse Practitioner | 833 Princeton Ave Sw Ste 200a, Birmingham, AL 35211-1321 | 2019-04-04 |
| 1467927848 | Jacob Ray | Nurse Practitioner | 833 Princeton Ave Sw Ste 200a, Birmingham, AL 35211-1321 | 2018-10-11 |
| 1740308121 | Raymond A Mock | Nurse Practitioner | 833 Princeton Ave Sw Ste 200a, Birmingham, AL 35211 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982216123 | Tara Brown | Technician | 2007 Goldwire Trce, Birmington, AL 35211 | 2020-08-19 |
| 1477173318 | Jeffrey D. Cooney | Student in an Organized Health Care Education/Training Program | 833 Princeton Avenue Sw, Professional Office Bldg 3, Suite 200-e, Birmingham, AL 35211 | 2020-04-21 |
| 1982253852 | Josephine Cook | Technician | 1255 18th St Sw, Birmingham, AL 35211 | 2019-09-04 |
| 1154882322 | Stephen Jenkins | Registered Nurse | 701 Princeton Ave. Sw, Birmingham, AL 35211 | 2019-03-28 |
| 1780107052 | Negar Massah | Dentist | 2850 Venice Rd, Apt 1135, Birmingham, AL 35211 | 2017-07-19 |
| 1417075342 | Joseph Edward Mcjunkin | Pharmacist | 1308-tuscaloosa Ave.sw, Birmingham, AL 35211 | 2007-03-27 |
| 1669500880 | Prakash Chand Kansal | Internal Medicine | 801 Princeton Avenue, Pob 1, Suite 332., Birmingham, AL 35211 | 2007-03-01 |
| 1588717284 | Laquinta Johnson | Occupational Therapist | 420 10th St Sw, Birmingham, AL 35211 | 2007-01-18 |
| 1174613160 | Praveen Jetty | Psychiatry & Neurology | 401 Tuscaloosa Ave. S.w., Suite 110, Birmingham, AL 35211 | 2006-10-13 |
| 1326134180 | Yahya M Sabri | Obstetrics & Gynecology | 801 Princton Ave, Prof Office Bldg I Suite 332, Birmingham, AL 35211 | 2006-10-05 |
| Find all providers in zip 35211 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679295 | Maltiece O'neal El | Physician Assistant | 1331 14th Ave S Apt 12, Birmingham, AL 35205-5341 | 2020-11-02 |
| 1477164580 | Rebecca Diane Davis | Physician Assistant | 701 S. 19th St, Lhr 112, Birmingham, AL 35233 | 2020-08-12 |
| 1437769981 | Kelsey Marie Robinson | Physician Assistant | 2400 Mahaska Dr, Birmingham, AL 35244-2241 | 2020-08-08 |
| 1508475740 | Stephanie Joseph Gilkey | Physician Assistant | 1505 Pleasant Ct, Birmingham, MI 48009-2909 | 2020-07-23 |
| 1619591922 | Alec Weil | Physician Assistant | 1400 19th St S, Birmingham, AL 35205-4903 | 2020-06-02 |
| 1689293888 | Molly Lynn Miller | Physician Assistant | 619 19th St S Fl 6, Birmingham, AL 35249-1900 | 2020-04-09 |
| 1730712571 | Emily Fallon Wilson | Physician Assistant | 3686 Grandview Pkwy Ste 530, Birmingham, AL 35243-3405 | 2020-02-20 |
| 1538791074 | Caroline Garrison Inge | Physician Assistant | 2700 10th Ave S Ste 505, Birmingham, AL 35205-1250 | 2020-02-11 |
| 1770114274 | Christopher Hopfner | Physician Assistant | 1809 Haynes St, Birmingham, MI 48009-6822 | 2020-02-03 |
| 1821550815 | Rebecca Brajak | Physician Assistant | 48 Medical Park Dr E Ste 150, Birmingham, AL 35235-3456 | 2019-04-01 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35211 |
Please comment or provide details below to improve the information on MARK JACOBS.
| 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.