CHRIS JACOB DO NPI 1790163962

NPI Information

NPI: 1790163962
Provider Name: CHRIS JACOB, DO
Classification: Internal Medicine - 207RC0000X
Specialization: Cardiovascular Disease
Entity Type: Individual
PECOS Registration: Yes
Address: 1000 E PARIS AVE SE STE 200
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 685-3450

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NPI Details

Chris Jacob, DO is a cardiovascular disease internal medicine in Grand Rapids, MI with 11 years of experience. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Chris Jacob, DO NPI is 1790163962. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:2015

The provider's business location address is:

1000 E PARIS AVE SE STE 200
GRAND RAPIDS, MI
ZIP 49546-383
Phone: (616) 685-3450
Fax: (646) 685-3454

The NPI 1790163962 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 5/8/2015 and was last updated on 10/25/2025.

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	390200000X	Student in an Organized Health Care Education/Training Program		5101021621	MICHIGAN	No
2	207R00000X	Internal Medicine		5101021621	MICHIGAN	No
3	390200000X	Student in an Organized Health Care Education/Training Program		5151009894	MICHIGAN	No
4	207RI0011X	Internal Medicine	Interventional Cardiology	5101028038	MICHIGAN	No
5	208M00000X	Hospitalist		293779	NEW YORK	No
6	207RC0000X	Internal Medicine	Cardiovascular Disease	5101028038	MICHIGAN	Yes

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: 11/21/2025

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