John F Jacobs Iii (NPI# 1497184378, PAC ID# 8729217054) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1497184378 |
| PAC ID by PECOS | 8729217054 |
| Professional Enrollment ID | I20151111002271 |
| Full Name | John F Jacobs Iii |
| Organization Legal Name | GRAND AVENUE URGENT CARE LLC |
| Address |
3236 E Grand Ave Suite D Laramie WY 82070-5100 |
| Phone Number | 3077608602 |
| Gender | M |
| Medical School | WRIGHT STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4385936244 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 530025 | IVINSON MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3236 E Grand Ave, Suite D, Laramie, WY 82070-5100 | 3077608602 | GRAND AVENUE URGENT CARE LLC |
| Organization Legal Name | GRAND AVENUE URGENT CARE LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert M Martino | Preventative Medicine | Grand Avenue Urgent Care LLC | 3236 E Grand Ave, Suite D, Laramie, WY 82070-5100 |
| Philip Lerory Sanders | Nurse Practitioner | Grand Avenue Urgent Care LLC | 3236 E Grand Ave, Suite D, Laramie, WY 82070-5100 |
| Street Address |
3236 E GRAND AVE SUITE D |
| City | LARAMIE |
| State | WY |
| Zip | 82070-5100 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert M Martino | Preventative Medicine | Grand Avenue Urgent Care LLC | 3236 E Grand Ave, Suite D, Laramie, WY 82070-5100 |
| Philip Lerory Sanders | Nurse Practitioner | Grand Avenue Urgent Care LLC | 3236 E Grand Ave, Suite D, Laramie, WY 82070-5100 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Charles M Cupps | Chiropractic | 212 E Ivinson, Laramie, WY 82070-3039 | |
| Brent L Bondurant | Chiropractic | 212 E Ivinson Ave, Laramie, WY 82070-3039 | |
| Denise A Gill | Clinical Social Worker | 107 S 5th St, Laramie, WY 82070-3123 | |
| Shontay M Roe | Clinical Social Worker | 112 S 5th St, Laramie, WY 82070-3124 | |
| Charles W Denison | Psychologist, Clinical | 121 E Grand Ave, Suite 202, Laramie, WY 82070-3600 | |
| Larae Sue Stibitz | Clinical Social Worker | 121 E Grand Ave, Suite 216, Laramie, WY 82070-3600 | |
| Janet L Somlyay | Nurse Practitioner | 311 S 2nd St, Laramie, WY 82070-3611 | |
| Julia A Duncan | Nurse Practitioner | 502 S 4th St, Laramie, WY 82070-3704 | |
| Leah S White | Nurse Practitioner | 504 S 4th St, Laramie, WY 82070-3704 | |
| Teresa Jacobs Castano | Clinical Social Worker | 502 S 4th St, Laramie, WY 82070-3704 | |
| Find all physicians in zip 82070 | |||
| City | LARAMIE |
| Zip Code | 82070 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LARAMIE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on John F Jacobs Iii.
| 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.