JACOBS CLINIC, INC. (NPI# 1033508791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033508791 |
| Entity Type | Organization |
| Organization Name | JACOBS CLINIC, INC. |
| Practice Address |
403 Lister St A Waycross GA 31501-5225 |
| Practice Telephone | 9128168956 |
| Mailing Telephone | 9128168956 |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-01-20 |
| Authorized Official Name | ROBERT SCOTT JACOBS (NURSE PRACTITIONER/OWNER) |
| Authorized Official Telephone | 9128168956 |
| Authorized Official Credential | ARNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN121991NP | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
403 LISTER ST A |
| City | WAYCROSS |
| State | GA |
| Zip Code | 31501-5225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457894701 | James S. Blasko, M.d. P.C. | Family Medicine | 403 Lister St, Waycross, GA 31501-5225 | 2016-11-18 |
| 1629522032 | Henderson Family Practice, Inc | Clinic/Center | 403 Lister St, Suite A, Waycross, GA 31501-5225 | 2016-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962906115 | Davenport Health Pa | Family Medicine | 1401 Cherokee Drive, Waycross, GA 31501 | 2018-03-22 |
| 1962940478 | Blake Darren Aldridge | Physical Therapy Assistant | 401 Preston Street, Waycross, GA 31501 | 2017-02-03 |
| 1669922142 | Jebediah S. Christy Dds - Waycross Pllc | Dentist | 2271 Memorial Dr, Waycross, GA 31501 | 2016-10-10 |
| 1558721944 | Jana Kirby | Massage Therapist | 1599 Knight Ave., Kallman Chiropractic Center, Waycross, GA 31501 | 2016-02-29 |
| 1962877001 | Courtney Baldwin | Specialist/Technologist, Other | 2403 Spurgeon St, Waycross, GA 31501 | 2015-12-01 |
| 1912389784 | Grayson Stuart Griffis | Dentist | 2103 Tebeau St., Waycross, GA 31501 | 2015-06-29 |
| 1730561267 | Trishla Amit Desai | Internal Medicine | Memorial Satilla Health, 1900 Tebeau Street, Waycross, GA 31501 | 2015-06-20 |
| 1316330913 | Hanger Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 512 City Blvd Ste H, Waycross, GA 31501 | 2015-03-06 |
| 1942699079 | Jose Ramon Martinez | Anesthesiology | 701 City Blvd, Waycross, GA 31501 | 2015-01-13 |
| 1023356714 | Orthopedics Surgeons of Georgia, LLC | Orthopaedic Surgery | 2015 Alice Street, Waycross, GA 31501 | 2013-01-30 |
| Find all providers in zip 31501 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124649926 | Jessica Delores Johnson | Nurse Practitioner | 360 Ossie Davis Pkwy, Waycross, GA 31501-4566 | 2020-05-03 |
| 1164043055 | Shawana Mitchell Taylor | Nurse Practitioner | 1115 Porter St, Waycross, GA 31501-5640 | 2020-05-01 |
| 1700410644 | Emilie Ann King | Nurse Practitioner | 1707 Danora Dr, Waycross, GA 31501-4153 | 2020-03-01 |
| 1427609262 | Rilla Margaret Highsmith | Nurse Practitioner | 5675 Wooddell Dr, Waycross, GA 31503-4482 | 2019-09-23 |
| 1174003917 | Heather Franklin | Nurse Practitioner | 1815 Rhoda St, Waycross, GA 31503-1727 | 2018-08-21 |
| 1992292874 | Yotta Lasheka Burton | Nurse Practitioner | 1100 Atlantic Ave, Waycross, GA 31501-3255 | 2018-04-17 |
| 1548760622 | Utrena Donsha Grant | Nurse Practitioner | 1707 Saint Marys Dr, Waycross, GA 31501-5207 | 2018-02-15 |
| 1760939441 | Sara S Knox | Nurse Practitioner | 1712 Vernon St, Waycross, GA 31501-7358 | 2016-09-09 |
| 1871047399 | Lori Henderson | Nurse Practitioner | 624 Tebeau St, Waycross, GA 31501-4728 | 2016-08-12 |
| 1194009514 | Whitney Brooks Johnson | Nurse Practitioner | 2003a Pioneer Street, Waycross, GA 31501-6249 | 2011-10-04 |
| Find all providers in WAYCROSS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.