KATHY LANAE JACOBS RN
NPI 1639909773
Nurse Practitioner - Family in Layton, UT
About Kathy Lanae Jacobs Rn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KATHY LANAE JACOBS RN (NPI 1639909773) is an individual family provider in Layton, Utah, licensed in Utah (9796796-4405) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2026).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kathy Lanae Jacobs Rn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kathy Jacobs reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Layton, UT 84040
- Reassigned Medicare billing, Utah enrollment
- 270 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84041 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Kathy Jacobs's NPI number?
The NPI number for Kathy Jacobs is 1639909773. It was assigned to this individual provider in the NPPES registry on August 5, 2024.
Where is Kathy Jacobs located?
Kathy Jacobs practices at 425 S 100 W, Layton, UT 84041. The listed phone number is (801) 773-4840.
What is Kathy Jacobs's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kathy Jacobs enrolled in Medicare?
Yes. Kathy Jacobs is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kathy Jacobs's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kathy Jacobs reassigns Medicare benefits to Tanner Memorial Clinic (Layton, UT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kathy Jacobs's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kathy Jacobs accept?
Health plans from Molina Healthcare, Select Health and University of Utah Health Plans list Kathy Jacobs as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kathy Jacobs was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.
# Kathy Lanae Jacobs, RN · NPI 1639909773
Family physician in Layton, Utah. Individual provider, active in the CMS NPPES registry since August 5, 2024.
## Identity
- **NPI:** 1639909773 (Entity type: Individual)
- **Enumerated:** August 5, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 9796796-4405 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 425 S 100 W, Layton, UT 84041-5356
- **Phone:** (801) 773-4840
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Tanner Memorial Clinic (NPI 1760934533, Layton, UT), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2026
## Record status
- **NPPES last updated:** July 29, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1639909773) · Data from the CMS NPPES public registry.