Victoria Lee Jacoby (NPI# 1124417142, PAC ID# 5193035236) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1124417142 |
| PAC ID by PECOS | 5193035236 |
| Professional Enrollment ID | I20151102002436 |
| Full Name | Victoria Lee Jacoby |
| Organization Legal Name | MISSISSIPPI COUNTY HOSPITAL SYSTEM |
| Address |
1521 N 10th St A Great River Women's Clinic Blytheville AR 72315-1424 |
| Phone Number | 8708387277 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 9739230723 |
| Number of Group Practice Members | 16 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 040069 | GREAT RIVER MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1521 N 10th St A, Great River Women's Clinic, Blytheville, AR 72315-1424 | 8708387277 | MISSISSIPPI COUNTY HOSPITAL SYSTEM |
| Organization Legal Name | MISSISSIPPI COUNTY HOSPITAL SYSTEM |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sejal P Thakor | Family Medicine | Mississippi County Hospital System | 602 W Union Ave B, Mississippi County Primary Care Physicians, Osceola, AR 72370-3014 |
| Matthew Shelby | Certified Registered Nurse Anesthetist (crna) | Mississippi County Hospital System | 1520 N Division St, Great River Medical Center Anesthesia Department, Blytheville, AR 72315-1448 |
| Ahmed Hussain | Urology | Mississippi County Hospital System | 1100 Medical Dr, Blytheville, AR 72315-1425 |
| Anthony Daniels | Obstetrics/gynecology | Mississippi County Hospital System | 1521 N 10th St A, Great River Women's Clinic, Blytheville, AR 72315-1424 |
| Peggy S Darty | Nurse Practitioner | Mississippi County Hospital System | 1100 Medical Dr, Blytheville, AR 72315-1425 |
| Eric C Green | Nurse Practitioner | Mississippi County Hospital System | 1520 N Division St, Gerald Stiparu Md Hospitalist, Blytheville, AR 72315-1448 |
| Stephen Scott Pirtle | Family Medicine | Mississippi County Hospital System | 1100 Medical Dr, Blytheville, AR 72315-1425 |
| Kimberly D Hughes | Certified Registered Nurse Anesthetist (crna) | Mississippi County Hospital System | 1520 N Division St, Great River Medical Center Anesthesia Department, Blytheville, AR 72315-1448 |
| Stanley Gordon | Certified Registered Nurse Anesthetist (crna) | Mississippi County Hospital System | 1520 N Division St, Great River Medical Center Anesthesia Department, Blytheville, AR 72315-1448 |
| Pratapji T Thakor | Family Medicine | Mississippi County Hospital System | 1100 Medical Dr, Blytheville, AR 72315-1425 |
| Street Address |
1521 N 10TH ST A GREAT RIVER WOMEN'S CLINIC |
| City | BLYTHEVILLE |
| State | AR |
| Zip | 72315-1424 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony Daniels | Obstetrics/gynecology | Mississippi County Hospital System | 1521 N 10th St A, Great River Women's Clinic, Blytheville, AR 72315-1424 |
| Ronnie Wayne Dennis | Obstetrics/gynecology | Mississippi County Hospital System | 1521 N 10th St A, Great River Women's Clinic, Blytheville, AR 72315-1424 |
| Chimere A Ashley | Family Medicine | Mississippi County Hospital System | 1521 N 10th St A, Great River Women's Clinic, Blytheville, AR 72315-1424 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karen C Hester | Pediatric Medicine | Family Medicine Associates of Blytheville Pa | 1521 N 10th St, Suite C, Blytheville, AR 72315-1424 |
| Richard L Hester | Internal Medicine | Family Medicine Associates of Blytheville Pa | 1521 N 10th St, Suite C, Blytheville, AR 72315-1424 |
| James D. Russell | General Practice | Family Medicine Associates of Blytheville Pa | 1521 N 10th St, Suite C, Blytheville, AR 72315-1424 |
| Connie Kay Ash | Nurse Practitioner | Family Medicine Associates of Blytheville Pa | 1521 N 10th St, Suite C, Blytheville, AR 72315-1424 |
| Jonathan D White | Family Medicine | Diffine Family Practice Pllc | 1100 Medical Plaza Dr, Suite C, Blytheville, AR 72315-1425 |
| Ahmed Hussain | Urology | Mississippi County Hospital System | 1100 Medical Dr, Blytheville, AR 72315-1425 |
| Necole L Hughes | Nurse Practitioner | Diffine Family Practice Pllc | 1100 Medical Plaza Dr, Suite C, Blytheville, AR 72315-1425 |
| Peggy S Darty | Nurse Practitioner | Mississippi County Hospital System | 1100 Medical Dr, Blytheville, AR 72315-1425 |
| Stephen Scott Pirtle | Family Medicine | Mississippi County Hospital System | 1100 Medical Dr, Blytheville, AR 72315-1425 |
| David M Lewis | Otolaryngology | Ne Arkansas Otolaryngology Facial Surgery P A | 1100 Medical Dr, Blytheville, AR 72315-1425 |
| Find all physicians in zip 72315 | |||
| City | BLYTHEVILLE |
| Zip Code | 72315 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | BLYTHEVILLE + NURSE PRACTITIONER |
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| 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.