LAWRENCE M. JACOBY, M.D., PC (NPI# 1942405246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942405246 |
| Entity Type | Organization |
| Organization Name | LAWRENCE M. JACOBY, M.D., PC |
| Practice Address |
18 W Avon Rd Avon CT 06001-3583 |
| Practice Telephone | 8606731667 |
| Practice Fax Number | 8606731544 |
| Mailing Telephone | 8606731667 |
| Mailing Fax Number | 8606731544 |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. JODIE JACOBY (OFFICE MANAGER) |
| Authorized Official Telephone | 8606731667 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 174400000X | Specialist | 016756 | CT | Other Service Providers |
| X | 174400000X | Specialist | 022522 | CT | Other Service Providers |
| X | 363A00000X | Physician Assistant | 000178 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | BCBS ANTHEM CONNECTICUT | 010016756CT01 | 01 |
| CT | AETNA | 44259 | 01 |
| CT | CONNECTICARE DR. | 701896 | 01 |
| DE | BCBS ANTHEM CT -- PA | 290000178CT01 | 01 |
| CT | OXFORD | P1595383 | 01 |
| CT | CONNECTICARE PA | 18000 | 01 |
| CT | PHCS | 731541 | 01 |
| Street Address |
18 W AVON RD |
| City | AVON |
| State | CT |
| Zip Code | 06001-3583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457407835 | Sean Christopher Mcloughlin | Optometrist | 18 W Avon Rd, Avon, CT 06001-3583 | 2007-01-26 |
| 1578038824 | Myeyedr Optometry of Connecticut, LLC | Optometrist | 18 W Avon Rd, Avon, CT 06001-3583 | 2018-10-12 |
| 1306100664 | Pamela Carol Malchoff | Optometrist | 18 W Avon Rd, Avon, CT 06001-3583 | 2012-07-01 |
| 1831420470 | Burke-mcloughlin Eye Associates, PC | Optometrist | 18 W Avon Rd, West Building, Avon, CT 06001-3583 | 2010-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285247338 | Alledran Med LLC | Durable Medical Equipment & Medical Supplies | 47 Avonwood Road, Unit #218, Avon, CT 06001 | 2020-08-28 |
| 1265053391 | 001care Inc | In Home Supportive Care | 20 Tower Lane, Avon, CT 06001 | 2020-04-29 |
| 1649813783 | Peoplesdental, P.C. | Dentist | 20 W Avon Rd Ste 104, Avon, CT 06001 | 2019-10-22 |
| 1740822063 | I E Consulting, LLC | Home Health | 1-5 East Main Street, Avon, CT 06001 | 2019-10-09 |
| 1598324261 | Prima Labs, LLC | Orthopaedic Surgery | Dr. Alexandra 58, Kezmarok, SLOVAKIA 06001 | 2019-06-06 |
| 1194220996 | Theresa L. Hixson | Social Worker | 152 Simsbury Rd., Building 9, Avon, CT 06001 | 2018-03-26 |
| 1851809974 | Kathleen Ann Subasic | Occupational Therapist | 19 Stockbridge Dr, Avon, CT 06001 | 2018-01-11 |
| 1801254297 | Vanessa Brodie | Psychologist | 395 W Avon Rd Ste 1, Avon, CT 06001 | 2016-02-01 |
| 1346614468 | Bryan Lilley | Physical Therapist | 34 Dale Rd., 202, Avon, CT 06001 | 2015-12-01 |
| 1073947446 | Rahel K. Saroff Counseling Services LLC | Counselor | 7 Towpath Lane, Avon, CT 06001 | 2013-08-21 |
| Find all providers in zip 06001 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922459072 | Latasha Jones | Specialist | 1455 Mulberry Ln, Avon, OH 44011-4033 | 2016-06-29 |
| 1275959447 | Michelle Fries | Specialist | 87 Wadsworth Ave, Avon, NY 14414-1125 | 2014-03-12 |
| 1992131049 | Arm Specialists, LLC | Specialist | 1389 Longleaf St, Avon, IN 46123-7199 | 2013-09-20 |
| 1093031510 | Jeffrey Steven Draper | Specialist | 160 W. Beaver Creek Blvd., Suite C, Avon, CO 81620 | 2010-04-08 |
| 1215100706 | Noah Philleo Parker | Specialist | 1115 Ronald Reagan Pkwy Ste 148, Avon, IN 46123-6913 | 2008-04-07 |
| 1285841007 | Karla Kay Alenduff | Specialist | 75 S County Road 400 E, Avon, IN 46123-9410 | 2007-05-17 |
| 1770605552 | Gary W. Cage Md, Pa | Specialist | 70 Benchmark Road, Suite 203, Avon, CO 81620 | 2007-04-04 |
| 1669471983 | Michael Donegan | Specialist | 490 Collins St, Avon, NY 14414-1466 | 2005-07-19 |
| 1043568405 | Fara A Linquist | Specialist | 33100 Cleveland Clinic Blvd, Avon, OH 44011-1390 | 2012-08-16 |
| 1124331525 | Carrie Elizabeth Poole | Specialist | 302 W Main St, Suite 204, Avon, CT 06001-3681 | 2010-07-14 |
| Find all providers in AVON | ||||
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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.