1. Home
  2. Directory
  3. Virginia
  4. Portsmouth
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

DR. JACOB JOHN RADABAUGH MD
NPI 1043914625
Student in an Organized Health Care Education/Training Program in Portsmouth, VA

Active since March 28, 2023PECOS Enrolled
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708(757) 953-5000 Get Directions Write a Review

NPPES record last updated: March 28, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Jacob John Radabaugh Md NPPES

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

DR. JACOB JOHN RADABAUGH MD (NPI 1043914625) is an individual student in an organized health care education/training program in Portsmouth, Virginia and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043914625
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. JACOB JOHN RADABAUGHCredential: MD
Location Address620 JOHN PAUL JONES CIRPortsmouth, VA 23708-2111
Mailing Address620 John Paul Jones CirPortsmouth, VA 23708-2111 · (757) 953-5000
Phone(757) 953-5000
Sole ProprietorNo
Enumeration DateMarch 28, 2023
NPPES CertifiedMarch 28, 2023
✔ NPI 1043914625 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

620 JOHN PAUL JONES CIR, Portsmouth, VA 23708
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jacob John Radabaugh Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

MEREDITH TVERDOSI CRNA
Nurse Anesthetist, Certified Registered
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-3238
ERIC FRANCIS SULAVA
Emergency Medicine
620 JOHN PAUL JONES CIR, NAVAL MEDICAL CENTER PORTSMOUTH
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-0669
MRS. TIFFNY KUPER RHH
Dental Hygienist
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-2711
DR. LAKEISHA GOODE PHARMD
Pharmacist
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-7462
JASMINE WOOD MD
Surgery
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-1895
NICHOLAS FANSELOW
General Practice
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-0669
DR. DAVID JESSEN MD
Military Health Care Provider
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-2518
MRS. WILLAR MAE BAUM L.C.S.W.
Social Worker (Clinical)
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-9767

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 Jacob Radabaugh's NPI number?

The NPI number for Jacob Radabaugh is 1043914625. It was assigned to this individual provider in the NPPES registry on March 28, 2023.

Where is Jacob Radabaugh located?

Jacob Radabaugh practices at 620 John Paul Jones Cir, Portsmouth, VA 23708. The listed phone number is (757) 953-5000.

What is Jacob Radabaugh's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jacob Radabaugh enrolled in Medicare?

Yes. Jacob Radabaugh is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Radabaugh was last updated on March 28, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.