JEFFRY ALAN JACOBS MEDICAL DOCTOR NPI 1063477545

NPI Information

NPI: 1063477545
Provider Name: JEFFRY ALAN JACOBS, MEDICAL DOCTOR
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

PECOS Registration: Yes

Address:
3608 FARAON ST
SAINT JOSEPH, MO
ZIP 64506
Phone: (816) 232-4417
Get Directions

Jeffry Alan Jacobs, MEDICAL DOCTOR is a child and adolescent psychiatry psychiatry neurology in Saint Joseph, MO with 25 years of experience. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. Jeffry Alan Jacobs, MEDICAL DOCTOR NPI is 1063477545. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
Graduation Year:1999

The provider's business location address is:

3608 FARAON ST
SAINT JOSEPH, MO
ZIP 64506-044
Phone: (816) 232-4417

The NPI 1063477545 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/19/2006 and was last updated on 6/8/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0800X	Psychiatry & Neurology	Psychiatry	35908KY	KENTUCKY	No
2	2084P0800X	Psychiatry & Neurology	Psychiatry	MD38701	TENNESSEE	No
3	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	MD60579729	WASHINGTON	No
4	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	2022007260	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200108213	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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