SUSAN JACOB (NPI# 1306315130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306315130 |
| Entity Type | Individual |
| Full Name | SUSAN JACOB |
| Credential | NP |
| Practice Address |
1380 River Bend Dr Dallas TX 75247-4914 |
| Mailing Address |
1345 River Bend Dr Ste 200 Dallas TX 75247-6945 |
| Practice Telephone | 2147436175 |
| Enumeration Date | 2018-11-22 |
| Last Update Date | 2019-11-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP139784 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821468257 | Susan Jacob | Nurse Practitioner | 212 Angela Ln, Stafford, TX 77477 | 2015-09-28 |
| 1699865881 | Susan C Jacob | Allergy & Immunology | 801 Alma St, Tomball, TX 77375 | 2006-10-16 |
| 1245246503 | Susan M. Jacob | Counselor | 1101 Dove St, Suite 160, Newport Beach, CA 92660-2839 | 2006-07-31 |
| 1356964431 | Susan Jacob | Student in an Organized Health Care Education/Training Program | 3459 5th Ave Ste 9, Pittsburgh, PA 15213-3236 | 2020-05-22 |
| 1801134390 | Susan Biji Jacob | Nurse Practitioner | 4400 N Lincoln Blvd, Oklahoma City, OK 73105-5104 | 2013-01-18 |
| 1487991246 | Susan Jacob | Pharmacist | 5473 Nw Saint James Dr, Port Saint Lucie, FL 34983-3444 | 2013-01-12 |
| 1467675819 | Susan Vivian Jacob | Psychologist | 14 Vanderventer Ave, Port Washington, NY 11050-3737 | 2007-04-11 |
| 1568685436 | Susan Jacob | Nurse Practitioner | 710 W 168th Street, New York, NY 10032-2699 | 2007-04-10 |
| 1538207220 | Susan Jacob | Family Medicine | 231 Albert Sabin Way, Cincinnati, OH 45267-2827 | 2007-02-02 |
| 1508951872 | Susan Jacob | Family Medicine | 55 Brendon Way, Suite 100, Zionsville, IN 46077-1955 | 2006-10-04 |
| Street Address |
1380 RIVER BEND DR |
| City | DALLAS |
| State | TX |
| Zip Code | 75247-4914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689662678 | Dallas Metrocare Services | Counselor | 1380 River Bend Dr, Dallas, TX 75247-4914 | 2005-10-12 |
| 1750894150 | Evita Lambert | Occupational Therapy Assistant | 1380 River Bend Dr, Dallas, TX 75247-4914 | 2017-11-08 |
| 1174052336 | Channing Moran Anderson | Counselor | 1380 River Bend Dr, Dallas, TX 75247-4914 | 2017-06-09 |
| 1669918488 | Esiah Allen | Nurse Practitioner | 1380 River Bend Dr, Dallas, TX 75247-4914 | 2017-01-18 |
| 1528504412 | Orlinda Mapa | Nurse Practitioner | 1380 River Bend Dr, Dallas, TX 75247-4914 | 2017-01-16 |
| 1356892707 | Lolade Oyetunji | Specialist/Technologist | 1380 River Bend Dr, Suite 200, Dallas, TX 75247-4914 | 2016-10-20 |
| 1265982730 | Louise Preston | Counselor | 1380 River Bend Dr, Dallas, TX 75247-4914 | 2016-10-09 |
| 1053860148 | Oluyemi Shorunke | Nurse Practitioner | 1380 River Bend Dr, Dallas, TX 75247-4914 | 2016-09-29 |
| 1861844359 | George Alapat | Counselor | 1380 River Bend Dr, Dallas, TX 75247-4914 | 2016-07-07 |
| 1699124164 | Eunice Akiny Ogodo-ochuodho | Nurse Practitioner | 1380 River Bend Dr, Dallas, TX 75247-4914 | 2016-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558973842 | Paramount Medical Rehabilitation LLC | Clinic/Center | 8585 North Stemmons Freeway Ste 107-s, Dallas, TX 75247 | 2020-08-19 |
| 1750916144 | Sunshine Kids Pediatric Day Center, LLC | Nursing Care | 9127-9131 King Arthur Boulevard, Dallas, TX 75247 | 2020-03-06 |
| 1740789924 | Jennifer Pauli | Nurse Practitioner | 7610 N Stemmons Fwy Ste 360, Dallas, TX 75247 | 2018-02-02 |
| 1669991097 | Kai Medical Laboratories, LLC | Pathology | 8230 Elmbrook Dr Ste 200, Dallas, TX 75247 | 2017-09-18 |
| 1174055610 | Hoa Perkins | Technician/Technologist | 1499 Regal Row Suite 505a, Dallas, TX 75247 | 2017-04-03 |
| 1376910018 | Integron LLC | Clinical Medical Laboratory | 5139 Sharp Street, Dallas, TX 75247 | 2015-08-28 |
| 1710364575 | T.e.a.m. | Community/Behavioral Health | 1140 Empire Central Blvd, 520, Dallas, TX 75247 | 2015-04-30 |
| 1093053126 | Guardian Health Systems Aurora | Pharmacy | 7920 Elmbrook Drive Suite 108, Suite 108, Dallas, TX 75247 | 2013-01-24 |
| 1457665317 | Pediatric Home Healthcare, LLC | Home Health | 1341 W Mockingbird Ln Ste 245e, Dallas, TX 75247 | 2010-08-03 |
| 1275846388 | Another Chancee, Inc. | Social Worker | 1140 Empire Central Drive, Suite 260, Dallas, TX 75247 | 2010-07-17 |
| Find all providers in zip 75247 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366052805 | Deadra Jordan | Nurse Practitioner | 5995 Summerside Dr Unit 795142, Dallas, TX 75379-0095 | 2020-08-07 |
| 1083235691 | Annemarie Osondu Odo | Nurse Practitioner | 9450 Skillman St Ste 120, Dallas, TX 75243-8235 | 2020-05-05 |
| 1740811934 | Kellie Lynn Westmoreland | Nurse Practitioner | 7777 Forest Ln Ste 833, Dallas, TX 75230-2571 | 2020-01-28 |
| 1346871696 | Ebote Ngite Nnoko | Nurse Practitioner | 108 Crescent Woode Dr, Dallas, GA 30157-5725 | 2020-01-27 |
| 1689238461 | Ican Medics and Psych Services Pllc | Nurse Practitioner | 9535 Forest Ln Ste 109, Dallas, TX 75243-5934 | 2019-04-26 |
| 1942773643 | Jo Kutty Kurian | Nurse Practitioner | 6363, Forest Park Road, 7th Floor, Suite 749, Dallas, TX 75390-9121 | 2019-01-04 |
| 1528538170 | Angel Laamber Adams | Nurse Practitioner | 7777 Forest Lane Suite C 833, Dallas, TX 75230 | 2018-11-27 |
| 1114495983 | Nwamaka Ngumezi | Nurse Practitioner | 3417 Gaston Ave Ste 815, Dallas, TX 75246-2034 | 2018-11-08 |
| 1811406150 | Justin Neal Mehan | Nurse Practitioner | 712 N Washington Ave Ste 411, Dallas, TX 75246-1626 | 2017-09-28 |
| 1114321775 | Shane Tipton | Nurse Practitioner | 6363 Forest Park Road 7th Floor Ste 749, Dallas, TX 75390-4426 | 2014-10-10 |
| Find all providers in DALLAS | ||||
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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.