MARY ANN JACOB (NPI# 1194741041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194741041 |
| Entity Type | Individual |
| Full Name | MARY ANN JACOB |
| Credential | M.D. |
| Practice Address |
2841 Debarr Rd Suite 45 Anchorage AK 99508-2932 |
| Practice Telephone | 9072740274 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 3150 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MD04901 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518425982 | Mary Deena Jacob | Nurse Practitioner | 2865 Mcdermott Rd #225, Plano, TX 75025 | 2019-03-05 |
| 1124537667 | Mary Jacob | Dentist | 334 Broadway, Revere, MA 02151-5016 | 2017-09-27 |
| 1164774071 | Mary Jacob | Pharmacist | 16 S Waukegan Rd, Deerfield, IL 60015-5216 | 2012-10-03 |
| 1225321755 | Mary Sunny Jacob | Emergency Medicine | 2150 Pennsylvania Ave Nw, Washington, DC 20037-3201 | 2011-05-17 |
| 1396776571 | Mary R Jacob | Clinical Nurse Specialist | 1600 S Orlando Ave, Winter Park, FL 32789-5547 | 2006-07-05 |
| 1659348399 | Mary Anne Jacob | Obstetrics & Gynecology | 6545 France Avenue South, Suite 540, Edina, MN 55435 | 2006-03-01 |
| 1083612246 | Mary Casey Jacob | Psychologist | 263 Farmington Ave, Farmington, CT 06030-0001 | 2005-07-12 |
| Street Address |
2841 DEBARR RD SUITE 45 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-2932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396748844 | Susan Canafax | Nurse Practitioner | 2841 Debarr Rd, Ste 25, Anchorage, AK 99508-2967 | 2005-05-28 |
| 1588113203 | Rebecca Libal | Nurse Practitioner | 2841 Debarr Rd, Suite 100, Anchorage, AK 99508-2958 | 2016-09-22 |
| 1619370319 | Alaska Regional Medical Group, LLC | Family Medicine | 2841 Debarr Rd, Anchorage, AK 99508-2958 | 2014-10-08 |
| 1497021588 | Radiology Services of Alaska Inc. | Radiology | 2841 Debarr Rd, Suite 12, Anchorage, AK 99508-2958 | 2012-03-22 |
| 1770857765 | Susan Canafax, Fnp | Nurse Practitioner | 2841 Debarr Rd, Suite 25, Anchorage, AK 99508 | 2012-03-08 |
| 1639463953 | Full Spectrum Pediatrics, PC | Clinic/Center | 2841 Debarr Rd, Bldg A, Suite 23, Anchorage, AK 99508-2958 | 2011-06-03 |
| 1578864575 | Joshua D Hedberg | Physician Assistant | 2841 Debarr Rd, Suite #22, Anchorage, AK 99508-2958 | 2010-11-06 |
| 1437462363 | Mary Ann Jacob, M.d., LLC | Pediatrics | 2841 Debarr Rd, Suite 45, Anchorage, AK 99508-2958 | 2010-07-20 |
| 1831344050 | Donald W. Dippe Md A Professional Corporation | Ophthalmology | 2841 Debarr Rd, Suite 35, Anchorage, AK 99508-2967 | 2008-12-02 |
| 1659521888 | J. Ross Tanner, D.o. LLC | Internal Medicine | 2841 Debarr Rd, Suite 43, Anchorage, AK 99508-2932 | 2008-09-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780195727 | Amanda Kathleen Dunlap | Pediatrics | 3340 Providence Dr Ste A-452, Anchorage, AK 99508-4691 | 2017-10-17 |
| 1841663945 | Jennifer Elisabeth Austin | Pediatrics | 751 E 36th Ave Ste 100, Anchorage, AK 99503 | 2015-11-11 |
| 1821409137 | Denise Frohlich Jones | Pediatrics | Alaska Neonatology Assoc, 3340 Providence Dr. Suite 366, Anchorage, AK 99508 | 2014-05-08 |
| 1780003376 | Carolyn Roloff | Pediatrics | 3200 Providence Dr Fl 3, Anchorage, AK 99508 | 2014-04-10 |
| 1154755056 | Begich School Based Health Center | Pediatrics | 7440 Creekside Center Dr, Anchorage, AK 99504-5234 | 2013-08-27 |
| 1710262175 | Anchorage School Based Health Centers | Pediatrics | 150 Bragaw St, Anchorage, AK 99508-1307 | 2011-10-18 |
| 1992936413 | J Robert Lovrich | Pediatrics | 10840 Vosikof Pl, Anchorage, AK 99507-6461 | 2009-07-31 |
| 1841429420 | Christina Diller | Pediatrics | 3260 Providence Dr Ste 532, Anchorage, AK 99508 | 2009-07-05 |
| 1467694620 | Polar Pediatrics | Pediatrics | 603 W. Tudor Rd, Anchorage, AK 99503 | 2009-04-01 |
| 1952570418 | Cory Vincent Noel | Pediatrics | 3841 Piper St Ste T345, Anchorage, AK 99508-4694 | 2008-02-28 |
| Find all providers in ANCHORAGE | ||||
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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.