ROBERT JACOB (NPI# 1497105605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497105605 |
| Entity Type | Individual |
| Full Name | ROBERT JACOB |
| Credential | PA-C |
| Practice Address |
180 Kennedy Memorial Dr Ste 201 Waterville ME 04901-4541 |
| Practice Telephone | 2078733753 |
| Mailing Telephone | 2078733753 |
| Enumeration Date | 2016-06-18 |
| Last Update Date | 2016-06-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA360 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215093315 | Robert B Jacob | Dentist | 4617 Ruffner St Ste 200, San Diego, CA 92111-2284 | 2006-12-31 |
| 1790709483 | Robert A Jacob | Orthopaedic Surgery | 1900 Bluegrass Ave, Suite 300, Louisville, KY 40215-1144 | 2006-07-26 |
| 1023017498 | Robert S Jacob | Anesthesiology | 2139 Auburn Ave, Cincinnati, OH 45219-2906 | 2005-07-19 |
| Street Address |
180 KENNEDY MEMORIAL DR STE 201 |
| City | WATERVILLE |
| State | ME |
| Zip Code | 04901-4541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093325649 | Orthopedic Physical Therapy | Physical Therapist | Orthopedic Physical Therapy, 234 College Ave, Waterville, ME 04901 | 2020-08-07 |
| 1790328771 | Elizabeth Saucier | Counselor | Discovery House 40 Airport Rd, Waterville, ME 04901 | 2019-10-23 |
| 1780233445 | Amy Marie Tardy | Counselor | 325 Kmd, Building D - Unit 4, 325 Kmd - Building D -- Unit 4, Waterville, ME 04901 | 2019-09-05 |
| 1457905911 | Waterville Audiology PC | Audiologist-Hearing Aid Fitter | 124 Silver Street, Waterville, ME 04901 | 2019-08-01 |
| 1629537048 | Samantha Sobel | Behavioral Analyst | 2 Seton Center Dr, Waterville, ME 04901 | 2019-03-15 |
| 1366916025 | Waterville Pharmacy | Pharmacy | 20 Concourse W, Waterville, ME 04901 | 2019-01-16 |
| 1699243733 | Thomas James Demers | Counselor | Discovery House, 40 Airport Road, Waterville, ME 04901 | 2018-11-07 |
| 1851892442 | Alishia M Austin | Counselor | Discovery House Ctc Waterville 40 Airport Rd, Waterville, ME 04901 | 2018-02-28 |
| 1336671056 | Douglas Joseph Dicola | Family Medicine | Mainegeneral Medical Center, 149 North St, Waterville, ME 04901 | 2017-03-31 |
| 1134660020 | Waterville Medical Supplies | Durable Medical Equipment & Medical Supplies | 325 Waterville Commons Drive, Waterville, ME 04901 | 2017-03-13 |
| Find all providers in zip 04901 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770130858 | Jacob Michael Dakota Redfox | Physician Assistant | 7610 Tournament Dr, Waterville, OH 43566-8702 | 2019-08-22 |
| 1760467179 | Kerri L Mcglew | Physician Assistant | 10 Washington St, Waterville, ME 04901 | 2005-12-08 |
| 1982169702 | Hanna Campbell | Physician Assistant | 16 Concourse W, Waterville, ME 04901-6007 | 2019-02-06 |
| 1144711656 | Rebecca Ann Sharpe | Physician Assistant | 200 Kennedy Memorial Dr, Waterville, ME 04901 | 2018-05-21 |
| 1093239634 | Sasha Thivierge-bonney | Physician Assistant | 211 Main St, Waterville, ME 04901-6117 | 2017-07-26 |
| 1245782135 | Megan Crane Wei | Physician Assistant | 149 North St, Waterville, ME 04901-4974 | 2016-10-26 |
| 1588117881 | Kelsey Stierwalt | Physician Assistant | 149 North St, Waterville, ME 04901-4974 | 2016-08-03 |
| 1750732889 | Cory Miller | Physician Assistant | 149 North St, Waterville, ME 04901-4974 | 2016-06-30 |
| 1508114430 | Marie Crocker Mason | Physician Assistant | 180 Kennedy Memorial Dr, Suite 301, Waterville, ME 04901-4540 | 2012-08-27 |
| 1689972440 | Sondra E Nantes | Physician Assistant | 200 Kennedy Memorial Dr, Waterville, ME 04901-4526 | 2011-03-03 |
| Find all providers in WATERVILLE | ||||
| City | WATERVILLE |
| Zip Code | 04901 |
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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.