Edwina Yvonne Jacobs, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

654339 Issued in TX

Practice address

615 W Round Bunch Rd
Bridge City, TX 77611-2434

Phone

(409) 735-7305

Fax

(888) 972-9401

NPI assigned

Oct 23, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

RHG of Texas PAGroup PAC ID 6608399829, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southern Home Health Home health agency, Nederland, TX, CCN 679237
• Christus Southeast Texas- St Elizabeth Hospital, Beaumont, TX, CCN 450034
• The Medical Center of Southeast Texas Hospital, Port Arthur, TX, CCN 450518

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edwina.jacobs.1@19036.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• RHG of Texas PA

  • Family Medicine Physician
  • Beaumont, TX
  • NPI 1013734243
  Medicare reassignment Care Compare group NPD
• Gordon and Parker, LLP

  • Family Medicine Physician
  • Orange, TX
  • NPI 1992873368
  Medicare reassignment
• Golden Triangle Family Care Center

  • Family Medicine Physician
  • Bridge City, TX
  • NPI 1669545067
  NPD
• C H Wilkinson Physician Network

  dba CHRISTUS Physician Group

  • Family Medicine Physician
  • Irving, TX
  • NPI 1457382947
  NPD (past)
• Lakeland Radiologists LTD

  • Diagnostic Radiology Physician
  • Charleston, IL
  • NPI 1891782090
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Health Southeast Texas

  dba CHRISTUS Southeast Texas - St. Elizabeth

  • General Acute Care Hospital
  • Beaumont, TX
  • NPI 1679557888
  Care Compare affiliation
• Hsa Port Arthur, LLC

  • General Acute Care Hospital
  • Port Arthur, TX
  • NPI 1194548073
  Care Compare affiliation
• Texas Health Care Group of the Golden Triangle, LLC

  dba Southern Home Health

  • Home Health Agency
  • Nederland, TX
  • NPI 1578673786
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1063765451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W ROUND BUNCH RD",
            "city": "BRIDGE CITY",
            "state": "TX",
            "postal_code": "776112434",
            "telephone_number": "409-735-7305",
            "fax_number": "888-972-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W ROUND BUNCH RD",
            "city": "BRIDGE CITY",
            "state": "TX",
            "postal_code": "776112434",
            "telephone_number": "409-735-7305",
            "fax_number": "888-972-9401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9632 Gaulding Rd",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777059450",
            "country_code": "US",
            "telephone_number": "409-679-4159",
            "fax_number": "888-972-9401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "EDWINA",
        "middle_name": "YVONNE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-23",
        "last_updated": "2023-03-07",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "654339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "AP122669",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCRIPTIVE AUTHORIZATION",
            "identifier": "13293",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING FAMILY PRACTICE NURSE PRACTITIONER LICENSE",
            "identifier": "654339",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gtfcc@live.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "updates",
            "address_1": "615 W Round Bunch Rd",
            "city": "Bridge City",
            "state": "TX",
            "country_code": "US",
            "postal_code": "776112434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hometown Therapy, PLLC
• Audrey Soileau Huddleston
• Amber M Hudson, D.D.S
• I Care LLC
• Obinna I Ifeadike, PHARM D
• Sabrina Jeanise, MS, RDN, LD
• Bryanna Kemp
• King's Pharmacy
• Lakes Area Medical (Sabine Neches Home Health)
• Jonathan an Le, DMD

• Family Nurse Practitioner in Bridge City, TX
• Providers in Bridge City, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.