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

JACOB WARREN KOOISTRA DEVRIES
NPI 1811658131
Student in an Organized Health Care Education/Training Program in Bloomington, IN

Active since January 08, 2022
701 E 17TH ST, BLOOMINGTON, IN 47408(812) 856-4465 Get Directions Write a Review

NPPES record last updated: January 8, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacob Warren Kooistra Devries NPPES

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

JACOB WARREN KOOISTRA DEVRIES (NPI 1811658131) is an individual student in an organized health care education/training program in Bloomington, Indiana and active in the NPI registry since January 2022.

NPPES Registry Identity

NPI1811658131
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACOB WARREN KOOISTRA DEVRIES
Location Address701 E 17TH STBloomington, IN 47408-1578
Mailing Address4425 Hickory Grove BlvdGreenwood, IN 46143-7445 · (317) 518-4674
Phone(812) 856-4465
Sole ProprietorNo
Enumeration DateJanuary 8, 2022
NPPES CertifiedJanuary 8, 2022
✔ NPI 1811658131 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.
701 E 17TH ST, Bloomington, IN 47408
Open in Google Maps ↗

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.

MARCUS AYINDE ELLINGTON
Specialist/Technologist (Athletic Trainer)
701 E 17TH ST
BLOOMINGTON, IN 47408
Monroe County (317) 270-8973
AVA KORINKE
Specialist/Technologist (Athletic Trainer)
701 E 17TH ST
BLOOMINGTON, IN 47408
Monroe County (925) 451-9270
MADISON THERESA KUMP ATC, SCAT, NREMT
Specialist/Technologist (Athletic Trainer)
701 E 17TH ST
BLOOMINGTON, IN 47408
Monroe County (317) 771-2661
MADELINE GRACE GANZ MSAT STUDENT
Specialist/Technologist (Athletic Trainer)
701 E 17TH ST
BLOOMINGTON, IN 47408
Monroe County (812) 855-1966
ABIGAIL D BENZINGER
Student in an Organized Health Care Education/Training Program
701 E 17TH ST
BLOOMINGTON, IN 47408
Monroe County (812) 855-1966
KAYLA ELIZABETH MEHNE
Specialist/Technologist (Athletic Trainer)
701 E 17TH ST
BLOOMINGTON, IN 47408
Monroe County (812) 631-2564
KATHERINE HOOK LAT, ATC
Specialist/Technologist (Athletic Trainer)
701 E 17TH ST
BLOOMINGTON, IN 47408
Monroe County (317) 727-7948
GRACIE SOGOCIO
Student in an Organized Health Care Education/Training Program
701 E 17TH ST
BLOOMINGTON, IN 47408
Monroe County (196) 681-2855

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 Devries's NPI number?

The NPI number for Jacob Devries is 1811658131. It was assigned to this individual provider in the NPPES registry on January 8, 2022.

Where is Jacob Devries located?

Jacob Devries practices at 701 E 17th St, Bloomington, IN 47408. The listed phone number is (812) 856-4465.

What is Jacob Devries's specialty?

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

When was this NPI record last updated?

The NPPES record for Jacob Devries was last updated on January 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.