JACOB LANDIS WILSON
NPI 1396234670
Student in an Organized Health Care Education/Training Program in Phoenix, AZ
About Jacob Landis Wilson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACOB LANDIS WILSON (NPI 1396234670) is an individual student in an organized health care education/training program in Phoenix, Arizona and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2018).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jacob Landis Wilson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
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.
PHOENIX, AZ 85008
PHOENIX, AZ 85008
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 Wilson's NPI number?
The NPI number for Jacob Wilson is 1396234670. It was assigned to this individual provider in the NPPES registry on May 2, 2018.
Where is Jacob Wilson located?
Jacob Wilson practices at 2601 E Roosevelt St, Phoenix, AZ 85008. The listed phone number is (602) 344-5084.
What is Jacob Wilson'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 Wilson enrolled in Medicare?
Yes. Jacob Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Jacob Wilson was last updated on November 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Jacob Landis Wilson · NPI 1396234670
Student in an Organized Health Care Education/Training Program provider in Phoenix, Arizona. Individual provider, active in the CMS NPPES registry since May 2, 2018.
## Identity
- **NPI:** 1396234670 (Entity type: Individual)
- **Enumerated:** May 2, 2018
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 2601 E ROOSEVELT ST, Phoenix, AZ 85008-4973
- **Phone:** (602) 344-5084
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** University Of Illinois College Of Med, class of 2018
## Record status
- **NPPES last updated:** November 21, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1396234670) · Data from the CMS NPPES public registry.