DR. STACEY LYNN JACOBS (NPI# 1881611390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881611390 |
| Entity Type | Individual |
| Full Name | DR. STACEY LYNN JACOBS |
| Credential | DMD |
| Practice Address |
19 Broadway Newport RI 02840-2937 |
| Mailing Address |
42 Farewell St Apt 2 Newport RI 02840-2564 |
| Practice Telephone | 4018450564 |
| Practice Fax Number | 4018474245 |
| Mailing Telephone | 4018450564 |
| Mailing Fax Number | 4018474245 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DEN02937 | RI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | TAXONOMY NUMBER | 1223G0001X | 01 |
| RI | NPI NUMBER | 1881611390 | 01 |
| RI | JS61781 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831239847 | Stacey Lee Jacobs | Dentist | 1313 Lorenzo, #3, Castroville, TX 78009-4532 | 2007-02-07 |
| 1295161933 | Stacey L Jacobs | Nurse Practitioner | 1319 Duncan Ave, Jeffersonville, IN 47130-3759 | 2013-09-25 |
| Street Address |
19 BROADWAY |
| City | NEWPORT |
| State | RI |
| Zip Code | 02840-2937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861439705 | East Bay Community Action Program | Clinic/Center | 19 Broadway, Newport, RI 02840-2937 | 2006-05-31 |
| 1104279546 | Jasma Patel | Dentist | 19 Broadway, Newport, RI 02840-2937 | 2016-07-21 |
| 1689074916 | Sara Phillips | Dentist | 19 Broadway, Newport, RI 02840-2937 | 2014-08-22 |
| 1114138773 | East Bay Communtiy Action Program | Community/Behavioral Health | 19 Broadway, Newport, RI 02840-2937 | 2007-05-25 |
| 1154447712 | Jeanne Marie Henry | Nurse Practitioner | 19 Broadway, Newport, RI 02840-2937 | 2007-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164993465 | Jacquelene Henderson | Counselor | 1341 West Main Road, Suite 16, Newport, RI 02840 | 2018-12-12 |
| 1619406683 | Lauren A Mcgovern | Social Worker | 8 Freebody St Ste 101, Newport, RI 02840 | 2017-06-05 |
| 1922388289 | Newport Family Foot Care, LLC | Podiatrist | 329 Broadway, Newport, RI 02840 | 2011-08-18 |
| 1578867255 | Nora K Griscom | Social Worker | 130 Bellevue Ave Ste 214, Newport, RI 02840 | 2011-01-10 |
| 1528200326 | Jessica Marie Welsh | Speech-Language Pathologist | 10 Friendship Street, Newport, RI 02840 | 2009-03-25 |
| 1023139037 | Elizabeth J Hayes | Counselor | Codac Inc, 93 Thames St, Newport, RI 02840 | 2007-04-03 |
| 1265551105 | Richatd Stengel | Dentist | East Bay Community Action Program, 19 Broadway, Newport, RI 02840 | 2007-03-29 |
| 1235262346 | Jon E Brett | Psychologist | 37 Powel Avenue, Newport, RI 02840 | 2007-03-14 |
| 1710018668 | James L Maher Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 120 Hillside Ave, Newport, RI 02840 | 2007-03-09 |
| 1285760736 | John Louis Salomone | Dentist | 73 Memorial Blvd, Newport, RI 02840 | 2007-02-26 |
| Find all providers in zip 02840 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265949903 | Jodeci Malixi | Dentist | 494 Highland Ave #1, Newport, VT 05855 | 2018-01-03 |
| 1396118824 | Anchor Dental | Dentist | 37 Long Wharf Mall, Newport, RI 02840-2906 | 2015-11-05 |
| 1679851257 | Benjamin J Messmer | Dentist | 23 E 8th St, Newport, KY 41071-1866 | 2011-07-29 |
| 1760678593 | Scott Allan Loiselle | Dentist | 612 Sw 9th St, Newport, OR 97365-4728 | 2007-09-14 |
| 1942416565 | Anne Marie Meyer | Dentist | 1660 N Coast Hwy, Newport, OR 97365-2357 | 2007-05-14 |
| 1265551105 | Richatd Stengel | Dentist | East Bay Community Action Program, 19 Broadway, Newport, RI 02840 | 2007-03-29 |
| 1023149903 | Michael C Benenati | Dentist | 50 John Stark Hwy, Newport, NH 03773-1811 | 2007-03-09 |
| 1437288065 | Douglas K Braun | Dentist | 40 E 9th St, Newport, KY 41071 | 2007-03-02 |
| 1295878486 | Masoud Hekmatyar | Dentist | 1847 Monmouth St # A, Newport, KY 41071-2637 | 2007-02-15 |
| 1972668572 | Grady A Gibson | Dentist | 701 Overton St, Newport, KY 41071-2064 | 2006-12-26 |
| Find all providers in NEWPORT | ||||
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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.