LORI JEAN JACOBS, APNP — NPI 1386664613 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers

CMS-1500 Box 24J / 33a • NPI

1386664613

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

363L00000X (CMS 50)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner

Box 32 Service Location & ZIP+4

2366 OAK RIDGE CIR, DE PERE, WI, 54115-9207

✓ 9-Digit EDI 837 ZIP+4 (54115-9207)

Practice Phone & Referral Fax

(920) 338-1111

Fax: (920) 339-5506

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1386664613 (LORI JEAN JACOBS, APNP) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1386664613` (NPI-1 Individual Practitioner)
Provider / Legal Name	LORI JEAN JACOBS, APNP
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner NUCC Code: `363L00000X` (Nurse Practitioner)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2366 OAK RIDGE CIR, DE PERE, WI, 54115-9207
Practice Telephone / Fax	Tel: (920) 338-1111 \| Fax: (920) 339-5506
Administrative Mailing Address	W12518 FABIAN LN, CRIVITZ, WI, 54114-7740
Enumeration & Last Sync	Enumerated: 2006-07-20 \| CMS Record Updated: 2026-08-17

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2366 OAK RIDGE CIR, DE PERE, WI, 54115-9207

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Plain-English Taxonomy & CMS Crosswalk (363L00000X)

What Does Taxonomy Code 363L00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363L00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 50 (Nurse Practitioner)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Practitioner for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (LORI JEAN JACOBS, APNP)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`363L00000X` — Nurse Practitioner Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner	State: WI \| License: `2857` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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LORI JEAN JACOBS, APNP (NPI #1386664613)