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JACKSON JACOB CCP
NPI 1043622772
Perfusionist in Livonia, MI

Active since May 29, 2014
31330 SCHOOLCRAFT RD, STE 200, LIVONIA, MI 48150(734) 525-9712 Get Directions Write a Review

NPPES record last updated: May 29, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jackson Jacob Ccp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKSON JACOB CCP (NPI 1043622772) is an individual perfusionist provider in Livonia, Michigan and active in the NPI registry since May 2014.

NPPES Registry Identity

NPI1043622772
Entity TypeIndividualMale
Primary Taxonomy242T00000X
Provider Legal NameJACKSON JACOBCredential: CCP
Location Address31330 SCHOOLCRAFT RD, STE 200Livonia, MI 48150-2041
Mailing Address31330 Schoolcraft Rd, Ste 200Livonia, MI 48150-2041 · (734) 525-9712
Phone(734) 525-9712
Sole ProprietorNo
Enumeration DateMay 29, 2014
✔ NPI 1043622772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPerfusionistTechnologists, Technicians & Other Technical Service Providers
Taxonomy Code242T00000X
Definition
A perfusionist operates extracorporeal circulation and autotransfusion equipment during any medical situation where it is necessary to support or temporarily replace the patient's circulatory or respiratory function. The perfusionist is knowledgeable concerning the variety of equipment available to perform extracorporeal circulation functions and is responsible, in consultation with the physician, for selecting the appropriate equipment and techniques to be used.
31330 SCHOOLCRAFT RD, Livonia, MI 48150
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL E OSBORNE CCP
Perfusionist
31330 SCHOOLCRAFT RD, STE200
LIVONIA, MI 48150
Wayne County (734) 525-9712
MCKENZIE E DAVIDSON CCP
Perfusionist
31330 SCHOOLCRAFT RD, STE 200
LIVONIA, MI 48150
Wayne County (734) 525-9712
LAURA M ALVERNIA
Specialist/Technologist, Other
31330 SCHOOLCRAFT RD, STE 200
LIVONIA, MI 48150
Wayne County (734) 525-9712
MARC PREVAL
Perfusionist
31330 SCHOOLCRAFT RD, STE 200
LIVONIA, MI 48150
Wayne County (734) 525-9712
KENNETH NOLAN CCP
Perfusionist
31330 SCHOOLCRAFT RD, STE 200
LIVONIA, MI 48150
Wayne County (734) 525-9712
BRANDON LIVINGSTON
Perfusionist
31330 SCHOOLCRAFT RD, STE 200
LIVONIA, MI 48150
Wayne County (734) 525-9712
RYAN PAGNANELLI CCP
Perfusionist
31330 SCHOOLCRAFT RD, SUITE 200
LIVONIA, MI 48150
Wayne County (734) 525-9712
ANGEL O DIAZ
Perfusionist
31330 SCHOOLCRAFT RD, STE 200
LIVONIA, MI 48150
Wayne County (734) 525-9712

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackson Jacob's NPI number?

The NPI number for Jackson Jacob is 1043622772. It was assigned to this individual provider in the NPPES registry on May 29, 2014.

Where is Jackson Jacob located?

Jackson Jacob practices at 31330 Schoolcraft Rd Ste 200, Livonia, MI 48150. The listed phone number is (734) 525-9712.

What is Jackson Jacob's specialty?

The primary specialty registered for this NPI is Perfusionist with taxonomy code 242T00000X.

When was this NPI record last updated?

The NPPES record for Jackson Jacob was last updated on May 29, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.