Joseph R Jacobs (NPI# 1962507095, PAC ID# 2961306147) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1962507095 |
| PAC ID by PECOS | 2961306147 |
| Professional Enrollment ID | I20061220000207 |
| Full Name | Joseph R Jacobs |
| Organization Legal Name | MOSAIC MEDICAL |
| Address |
375 Nw Beaver St Prineville OR 97754-1802 |
| Phone Number | 5414470707 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF KANSAS SCHOOL OF MEDICINE |
| Graduation Year | 1972 |
| Primary Specialty | FAMILY PRACTICE |
| Group Practice PAC ID | 5395653497 |
| Number of Group Practice Members | 45 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380047 | ST CHARLES MEDICAL CENTER - BEND |
| Address | Phone | Organization |
|---|---|---|
| 375 Nw Beaver St, Prineville, OR 97754-1802 | 5414470707 | MOSAIC MEDICAL |
| 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 | 5414470707 | MOSAIC MEDICAL |
| Organization Legal Name | MOSAIC MEDICAL |
| Physicians | 58 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Randi Louise Duble | Nurse Practitioner | Mosaic Medical | 1250 Sw Veterans Way, Redmond, OR 97756-2585 |
| Keith William Bell | Physician Assistant | Mosaic Medical | 2084 Ne Professional Ct, Bend, OR 97701-6077 |
| Linda C Hatch | Nurse Practitioner | Mosaic Medical | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 |
| Eric L Foote | Physician Assistant | Mosaic Medical | 2965 Ne Conners Ave, Suite 280, Bend, OR 97701-7753 |
| Lisa L Kuettle | Nurse Practitioner | Mosaic Medical | 1700 Se Tempest Dr, Bend, OR 97702-1884 |
| Angela D Enos | Physician Assistant | Mosaic Medical | 850 Sw 4th St, Suite 101, Madras, OR 97741-9629 |
| Gerda E Tapelband | Internal Medicine | Mosaic Medical | 2084 Ne Professional Ct, Bend, OR 97701-6077 |
| Dana M Rhode | Family Medicine | Mosaic Medical | 850 Sw 4th St, Suite 101, Madras, OR 97741-9629 |
| Mark T Press | Nurse Practitioner | Mosaic Medical | 2084 Ne Professional Ct, Bend, OR 97701-6077 |
| Diana Burden | Nurse Practitioner | Mosaic Medical | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 |
| Street Address |
375 NW BEAVER ST |
| City | PRINEVILLE |
| State | OR |
| Zip | 97754-1802 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Linda C Hatch | Nurse Practitioner | Mosaic Medical | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 |
| Diana Burden | Nurse Practitioner | Mosaic Medical | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 |
| Brian J Sullivan | Family Medicine | Mosaic Medical | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 |
| Jennifer Foresman | Nurse Practitioner | Mosaic Medical | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 |
| Kathy Ingelse | Nurse Practitioner | Mosaic Medical | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 |
| Rebecca Roach | Family Medicine | Mosaic Medical | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 |
| Matthew Travis Mullane | Family Medicine | Mosaic Medical | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 |
| William C Claridge | Family Medicine | Mosaic Medical | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 |
| Taouea Juanita Vitousek | Clinical Social Worker | Mosaic Medical | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 |
| Martin L Smart | Family Medicine | Mosaic Medical | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Coby L Hanes | Chiropractic | 446 Nw 3rd St, Prineville, OR 97754-1757 | |
| Alison Michele Johnson | Clinical Social Worker | Mosaic Medical | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 |
| Paul J Slater | Chiropractic | Paul Jay Slater Dc PC | 240 Nw Claypool St, Prineville, OR 97754-1842 |
| Tobias D Joyce | Chiropractic | Paul Jay Slater Dc PC | 240 Nw Claypool St, Prineville, OR 97754-1842 |
| Garrick D Jackson | Clinical Social Worker | Lutheran Community Services Northwest | 365 Ne Court St, Prineville, OR 97754-1936 |
| Barbara E Gilbertson | Family Medicine | Lutheran Community Services Northwest | 365 Ne Court St, Prineville, OR 97754-1936 |
| Caroline H Gentry | Clinical Social Worker | Lutheran Community Services Northwest | 365 Ne Court St, Prineville, OR 97754-1936 |
| Mashelle D Lester | Clinical Social Worker | Lutheran Community Services Northwest | 365 Ne Court St, Prineville, OR 97754-1936 |
| William E Davis | Psychiatry | Lutheran Community Services Northwest | 365 Ne Court St, Prineville, OR 97754-1936 |
| Devora L Rubin | Clinical Social Worker | Lutheran Community Services Northwest | 365 Ne Court St, Prineville, OR 97754-1936 |
| Find all physicians in zip 97754 | |||
| City | PRINEVILLE |
| Zip Code | 97754 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | PRINEVILLE + FAMILY PRACTICE |
Please comment or provide details below to improve the information on Joseph R Jacobs.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.