JOHN JACOBS III


Address: 3236 E Grand Ave Ste D, Laramie, WY 82070-5100
Phone: 3077608602

JOHN JACOBS III (NPI# 1497184378) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497184378
Entity Type Individual
Full Name JOHN JACOBS III
Credential NP-C
Practice Address 3236 E Grand Ave Ste D
Laramie
WY 82070-5100
Practice Telephone 3077608602
Practice Fax Number 3074609880
Mailing Telephone 3077608602
Mailing Fax Number 3074609880
Enumeration Date 2013-11-01
Last Update Date 2018-11-14
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2100X Nurse Practitioner
Specialization: Acute Care
34286.1346 WY Physician Assistants & Advanced Practice Nursing Providers
N 363LF0000X Nurse Practitioner
Specialization: Family
APN.0990808-NP CO Physician Assistants & Advanced Practice Nursing Providers
N 363LF0000X Nurse Practitioner
Specialization: Family
RN2259982 MA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
WY P01679910 05

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Office Location

Street Address 3236 E GRAND AVE STE D
City LARAMIE
State WY
Zip Code 82070-5100

Providers in the same location

NPI Name Taxonomy Address Enumeration
1477109445 Philip Lerory Sanders IIi Nurse Practitioner 3236 E Grand Ave Ste D, Laramie, WY 82070-5100 2019-08-14
1982051850 Chris Otto Physician Assistant 3236 E Grand Ave Ste D, Laramie, WY 82070-5100 2016-05-19
1174983118 Grand Avenue Urgent Care, LLC Clinic/Center 3236 E Grand Ave Ste D, Laramie, WY 82070-5100 2016-03-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548875164 Roland Maldonado Registered Nurse 258 Nth Hayes Street, Laramie, WY 82070 2020-09-10
1528429917 Spark Community/Behavioral Health 903 S 9th Street, Laramie, WY 82070 2016-03-11
1578968509 Melissa Marie Allen Speech-Language Pathologist 1613 Clydesdale, Laramie, WY 82070 2014-11-04
1316362155 Charles M. Alexander Pharmacist 3112 E. Grand Ave, Laramie, WY 82070 2014-03-04
1447685706 Dale Warren Van Wig Pharmacist 544 N. Third St, Pharmacy, Laramie, WY 82070 2013-09-05
1558619973 Sarah Marie Pence Pharmacist 4005 East Grand Ave, Laramie, WY 82070 2012-08-15
1437435567 Stephanie Ingalls Case Manager/Care Coordinator 69 Osprey Rd., Laramie, WY 82070 2011-11-03
1457634040 The Clinic for Mental Health and Wellness Counselor 504 South 4th Street, Laramie, WY 82070 2011-09-21
1316177371 Patricia Ann Casey Occupational Therapist Laramie Care Center, 503 S. 18th St., Laramie, WY 82070 2009-07-23
1134322340 Linda K Cross Case Manager/Care Coordinator 315 So 8th, Laramie, WY 82070 2007-06-06
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Taxonomy Information

Taxonomy Code 363LA2100X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Acute Care

Taxonomy Definition

Definition to come...

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1972051423 Stephanie M Davis Nurse Practitioner 1230 E 1st St, Casper, WY 82601-2704 2016-09-13
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Competitor

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City LARAMIE
Zip Code 82070

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Dataset Information

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.

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