CRYSTAL JACOBS (NPI# 1578186722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578186722 |
| Entity Type | Individual |
| Full Name | CRYSTAL JACOBS |
| Practice Address |
146 Glovers Cross Rd Colerain NC 27924-9444 |
| Mailing Address |
1265 Fairway Ter Rocky Mount NC 27804-9619 |
| Practice Telephone | 2522878718 |
| Mailing Telephone | 2522878717 |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2020-05-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747A0650X |
Technician Specialization: Attendant Care Provider |
NC | Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194905067 | Crystal Jacobs | Case Manager/Care Coordinator | 3310 Perimeter Hill Drive, Nashville, TN 37211 | 2007-11-08 |
| Street Address |
146 GLOVERS CROSS RD |
| City | COLERAIN |
| State | NC |
| Zip Code | 27924-9444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861515918 | Barbara Jean Davenport | Lodging | 116 Chowan Shores Drive, Colerain, NC 27924 | 2007-04-06 |
| 1649352998 | Colerain Rescue Squad Inc | Ambulance | 110 Winton St, Colerain, NC 27924 | 2006-10-19 |
| 1174042907 | Vickie M Persaud | Day Training/Habilitation Specialist | 605 Thomas Nelson Street, Colerain, NC 27924-0134 | 2017-09-13 |
| 1568951986 | Tonya C Freeman | Custodial Care Facility | 404 W River St, Colerain, NC 27924-8879 | 2018-05-02 |
| 1275027294 | The Home Place | Custodial Care Facility | 404 W River St, Colerain, NC 27924-8879 | 2018-06-22 |
| 1649764762 | Tonya Clark Freeman | Custodial Care Facility | 404 W River St, Colerain, NC 27924-8879 | 2018-06-21 |
| 1619523651 | Eathelda Caldwell | Technician | 1008 Perrytown Rd, Colerain, NC 27924-8953 | 2019-08-15 |
| 1790851004 | Roanoke Chowan Community Health Center, Inc | Clinic/Center | 109 W River St, Colerain, NC 27924-9006 | 2006-11-28 |
| 1811400203 | Roanoke Chowan Community Health Center Inc | Pharmacy | 109 W River St, Colerain, NC 27924-9006 | 2017-11-08 |
| 1720518574 | Roanoke Chowan Community Health Center Inc | Pharmacy | 109 W River St, Colerain, NC 27924-9006 | 2017-06-14 |
| Find all providers in zip 27924 | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619523651 | Eathelda Caldwell | Technician | 1008 Perrytown Rd, Colerain, NC 27924-8953 | 2019-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164037057 | Alan Cairns Bonsall | Technician | 10127 Misty Moss Ct, Mint Hill, NC 28227-8120 | 2020-09-09 |
| 1962010108 | Angel Elliott | Technician | 911 Us Hwy 52 N, New London, NC 28127 | 2020-07-14 |
| 1013535533 | Frankie Bartholomew | Technician | 1802d White Level Rd, Louisburg, NC 27549-8270 | 2020-07-10 |
| 1497374854 | Brenda Irish | Technician | 270 Winchester Woods Dr, Murphy, NC 28906-6900 | 2020-04-15 |
| 1982231643 | Melody Poole | Technician | 506 Ocean Spray Dr, Cedar Point, NC 28584-9319 | 2020-03-24 |
| 1295366904 | Jessica Knadler | Technician | 132 Windsor Ln, Raeford, NC 28376-8251 | 2020-01-31 |
| 1568093417 | Diana Opiyo | Technician | 9940 Heathergate Ln, Mint Hill, NC 28227-4309 | 2020-01-30 |
| 1184264087 | Amiee Morgan Lara | Technician | 116 Waco Ave, Kannapolis, NC 28083-6364 | 2020-01-09 |
| 1598303752 | Crystal Hunt | Technician | 1941 Westhill Dr, Fayetteville, NC 28304-5256 | 2019-12-18 |
| 1295372258 | Gillianne Patrice Hodge | Technician | 3400 Orange Grove Rd, Hillsborough, NC 27278-7639 | 2019-12-09 |
| Find all providers with the same taxonomy | ||||
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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.