Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Jacob Michael Dakota Redfox, PA-C

Individual provider Physician Assistant · NPI 1770130858

Mr. Jacob Michael Dakota Redfox, PA-C is a Physician Assistant in Waterville, Ohio. Qualified in 2019, 7 years ago. Practices with Columbus Radiology Corp, a 289-clinician group and accepts Medicare assignment. Licensed in Michigan and Ohio.

Years since qualifying
7
Licensed in
MI, OH
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

7610 Tournament Dr
Waterville, OH 43566-8702
Phone: (419) 704-6634
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.006018RX (OH)
Physician Assistant Taxonomy 363A00000X · Licence 5601009468 (MI)

Record details

NPI number1770130858
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 22, 2019
Last updated in NPPESAugust 16, 2022
Certification dateAugust 16, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Columbus Radiology Corp — 289 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare