DR. KENNETH MICHAEL JACOB (NPI# 1437121829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437121829 |
| Entity Type | Individual |
| Full Name | DR. KENNETH MICHAEL JACOB |
| Credential | MD |
| Practice Address |
19460 Caladesi Dr Fort Myers FL 33967-5572 |
| Mailing Address |
19460 Caladesi Dr Apt/suite Fort Myers FL 33967-5572 |
| Practice Telephone | 9137070826 |
| Mailing Telephone | 9137070826 |
| Mailing Fax Number | 4177727019 |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2013-11-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
R3D70 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 12485021 | 01 | |
| KS | 100154570D | 05 | |
| MO | 203728035 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174780183 | Kenneth William Jacob | Counselor | 680 Park Ave W, Mansfield, OH 44906-3706 | 2008-05-19 |
| Street Address |
19460 CALADESI DR |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33967-5572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235614991 | Michelle Lynn Gerken | Nurse Practitioner | 8141 Pennsylvania Blvd, Fort Myers, FL 33967 | 2018-09-28 |
| 1659892370 | Mary Kathryn Mckeon | Occupational Therapist | 9025 King Rd W, Ft Myers, FL 33967 | 2017-07-03 |
| 1316321003 | Wal-mart Stores East, Lp | Technician/Technologist | 19975 S Tamiami Trail, Fort Myers, FL 33967 | 2015-07-13 |
| 1104970409 | Jennifer J. Paul | Registered Nurse | 17132 Alico Center Road, Suite 1, Fort Myers, FL 33967 | 2007-01-23 |
| 1194750935 | William A. Greider | Dentist | 19004 Birch Rd. Se, Ft. Myers, FL 33967 | 2006-07-11 |
| 1548271869 | Desiree Granados-fischel | Obstetrics & Gynecology | 19348 La Serena Dr, Fort Myers, FL 33967-0525 | 2006-08-11 |
| 1487644555 | Henry Donn Venable | Anesthesiology | 19324 La Serena Dr, Estero, FL 33967-0525 | 2005-10-28 |
| 1407146434 | Barrie Nicole Vilnius | Occupational Therapist | 8815 Largo Mar Dr, Fort Myers, FL 33967-0534 | 2011-04-11 |
| 1760805725 | Hearing Health In Home Care, LLC | Hearing Instrument Specialist | 19760 Maddelena Cir, Fort Myers, FL 33967-0537 | 2014-01-28 |
| 1891110128 | Derick Alexander Winn | Hearing Instrument Specialist | 19760 Maddelena Cir, Fort Myers, FL 33967-0537 | 2014-02-24 |
| Find all providers in zip 33967 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669997961 | Sw Florida Radiology LLC | Radiology | 3949 Evans Ave Ste 301b, Fort Myers, FL 33901-9313 | 2017-08-08 |
| 1346698669 | Irving Radiology, Inc | Radiology | 4110 Center Pointe Dr Ste 210, Fort Myers, FL 33916 | 2016-05-26 |
| 1851752257 | Lillian Palmon | Radiology | 11250 Mahogany Run, Fort Myers, FL 33913-8114 | 2016-03-11 |
| 1770739260 | Winston Dacosta Irving | Radiology | 1244 Walden Dr, Fort Myers, FL 33901 | 2008-08-15 |
| 1366646424 | Louis Thomas Magas | Radiology | 6311 South Pointe Blvd, Fort Myers, FL 33919-4901 | 2007-06-13 |
| 1851330153 | David S Schwartz | Radiology | 3230 Cypress Marsh Dr, Fort Myers, FL 33905-6250 | 2006-06-05 |
| 1851345862 | Otto J Kunst | Radiology | 13151 Parkline Dr, Fort Myers, FL 33913-7929 | 2006-05-22 |
| 1124078241 | Adam Fueredi | Radiology | 3660 Broadway, Fort Myers, FL 33901-8005 | 2006-05-11 |
| 1235187808 | Gail M Santucci | Radiology | 8791 Conference Dr, Suite 1, Fort Myers, FL 33919-5822 | 2006-05-05 |
| 1538121116 | Laurie Lynn Gutstein | Radiology | 6013 W Riverside Dr, Fort Myers, FL 33919-1636 | 2006-04-06 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33967 |
Please comment or provide details below to improve the information on DR. KENNETH MICHAEL JACOB.
| 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.