JACOB FOX

NPI 1982231494 · Internal Medicine · Anthem

Provider Status Assessment

Needs Review

Evidence across dimensions is contradictory — supporting and opposing signals are present.

Confidence: High

Evidence: 5317 items from 13 sources

Signals: 5 supporting · 0 opposing · 2 missing

Resolution: Mixed signals across dimensions prevent confident classification. Manual review recommended.

Data Source Signals

✓

NPPES

AURORA, 80045

Freshness: Aging (last updated 2023-06-30)

980 days since update

✓

Network Status

Listed with 8 carriers

anthem_co — in_network (commercial)
anthem_co — in_network (commercial)
uhc_colorado_co — in_network (commercial)
uhc_insurance_co — in_network (commercial)
uhc_services_co — in_network (commercial)
uhc_umr_co — in_network (commercial)
uhc_surest_co — in_network (commercial)
kaiser_co — in_network (commercial)

✓

DORA License

Active

—

Medicare

Not enrolled in Medicare (PECOS)

✗

Care Compare

Address mismatch with NPPES

LAKEWOOD, 80228

—

PECOS Enrollment

System Reasoning

Claim Under Evaluation

Provider is actively practicing and appropriately listed in carrier networks

Evidence Evaluated

FHIR Directory: No active FHIR endpoint despite carrier listings

NPPES Registry: Active NPI, registered in AURORA (record aging)

Colorado DORA License: License status: Active

Federal Exclusion Check: No federal exclusions found (OIG LEIE, SAM.gov)

Carrier Networks: Listed in 8 carrier networks

CMS Care Compare: Found in Care Compare with 1 location

Medicare Billing: No Medicare billing records available

PECOS Enrollment: PECOS enrollment status unknown

Trust Evaluation

identity:0.75Strong

licensure:0.90Strong

activity:

Dimension Scores

Composite0.71

Identity0.75 — Moderate

Active NPI with specialty classification

Licensure0.90 — Strong

Active Colorado DORA license confirmed

Activity0.40 — Weak

No Medicare billing · No electronic endpoint · No PECOS enrollment

Reachability0.60 — Moderate

Single address source (NPPES)

Network1.00 — Strong

Listed in multiple carrier networks

Why is this provider classified as “needs review”?

Evidence across dimensions is contradictory or specific concerns exist (unverified license, FHIR directory contradiction). Manual review recommended.

Carrier Network Listings

7 networks across 3 carriers

Anthem(1 network)

1 DOI 6C-3

Anthem Blue Cross Blue ShieldDOI 6C-3

View carrier →

UnitedHealthcare(5 networks)

1 DOI 6C-34 Federal TiC

UnitedHealthcare of ColoradoDOI 6C-3

View carrier →

UnitedHealthcare InsuranceFederal TiC

View carrier →

UnitedHealthcare ServicesFederal TiC

View carrier →

Related Investigations

All providers in Anthem Blue Cross Blue Shield networkView →All Internal Medicine providers statewideView →All providers in AURORA 80045View →All providers classified as Needs ReviewView →

Known Addresses

NPPESAURORA, 80045

Care CompareLAKEWOOD, 80228

Evidence

5317 items across 17 assertions from 13 sources

Connected Records

Colorado License

Expired

DORA

FHIR Directory Status

Not found in directory

FHIR: uhc

Practice Address

LAKEWOOD, 80228

cms_care_compare, NPPES

Carrier Network Listing

Listed in 7 carrier networks

TiC: Anthem Blue Cross Blue Shield, TiC: UnitedHealthcare Services, TiC: UnitedHealthcare Insurance, TiC: UnitedHealthcare (UMR), TiC: UnitedHealthcare Colorado, TiC: UnitedHealthcare (Surest), TiC: Kaiser Permanente

Order/Referring Eligibility

Record found

cms_order_refer

NPI Registration

Status: active

NPPES

entity_type

Record found

NPPES

Federal Exclusion Check

No exclusion found

OIG LEIE + SAM.gov

Evidence Lineage

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shield5258 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shield9 records ·weight 0.80 · Latest: Mar 14, 2026

Colorado License StatusTrust: 0.95

↓DORA3 records ·weight 0.60 · Latest: Mar 13, 2026

Matched via: primary

Colorado License StatusTrust: 0.95

↓DORA5 records ·weight 0.98 · Latest: Mar 6, 2026

Matched via: license_number

FHIR Directory StatusTrust: 0.90

Timeline

Mar 14, 2026Carrier listing: Anthem Blue Cross Blue Shield

Mar 13, 2026DORA license check: Expired

Mar 13, 2026DORA license check: Active

Mar 13, 2026FHIR directory lookup: not found

Mar 12, 2026Carrier listing: UnitedHealthcare Services

Mar 12, 2026Carrier listing: UnitedHealthcare Insurance

Mar 12, 2026Carrier listing: UnitedHealthcare (UMR)

Mar 12, 2026Carrier listing: UnitedHealthcare Colorado

Mar 11, 2026Carrier listing: UnitedHealthcare (Surest)

Mar 11, 2026Order/Referring Eligibility: record found

Mar 6, 2026

Evidence

Loading evidence lineage...

Disclaimer: This analysis uses publicly available federal and state data sources. It does not constitute a determination of provider status or network participation. Contact the provider or health plan directly to verify current status.

Evidence

5317 items across 17 assertions from 13 sources

Connected Records

Colorado License

Expired

DORA

FHIR Directory Status

Not found in directory

FHIR: uhc

Practice Address

LAKEWOOD, 80228

cms_care_compare, NPPES

Carrier Network Listing

Listed in 7 carrier networks

Order/Referring Eligibility

Record found

cms_order_refer

NPI Registration

Status: active

NPPES

entity_type

Record found

NPPES

Federal Exclusion Check

No exclusion found

OIG LEIE + SAM.gov

Evidence Lineage

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shield5258 records ·weight 0.80 · Latest: Mar 14, 2026

Carrier Network ListingTrust: 0.80

↓TiC: Anthem Blue Cross Blue Shield9 records ·weight 0.80 · Latest: Mar 14, 2026

Colorado License StatusTrust: 0.95

↓DORA3 records ·weight 0.60 · Latest: Mar 13, 2026

Matched via: primary

Colorado License StatusTrust: 0.95

↓DORA5 records ·weight 0.98 · Latest: Mar 6, 2026

Matched via: license_number

FHIR Directory StatusTrust: 0.90

Timeline

Mar 14, 2026Carrier listing: Anthem Blue Cross Blue Shield

Mar 13, 2026DORA license check: Expired

Mar 13, 2026DORA license check: Active

Mar 13, 2026FHIR directory lookup: not found

Mar 12, 2026Carrier listing: UnitedHealthcare Services

Mar 12, 2026Carrier listing: UnitedHealthcare Insurance

Mar 12, 2026Carrier listing: UnitedHealthcare (UMR)

Mar 12, 2026Carrier listing: UnitedHealthcare Colorado

Mar 11, 2026Carrier listing: UnitedHealthcare (Surest)

Mar 11, 2026Order/Referring Eligibility: record found

Mar 6, 2026