Cody J Jacob, MD
Student in an Organized Health Care Education/Training Program in Indianapolis, IN. Individual provider (NPI-1).
Details
- NPI
- 1760293153
- Entity type
- Individual (NPI-1)
- Name
- Cody J Jacob
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 15, 2025
- Certification date
- Jan 15, 2025
- Last updated
- Jan 15, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
340 W 10th St Ste 6200Indianapolis, IN 46202-3082
Phone 317-274-8157
Mailing address
340 W 10th St Ste 6200Indianapolis, IN 46202-3082
Phone 317-274-8157
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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