Individual provider Active NPI

William Scott Jacobs

  • Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1114171154
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
748515 Issued in TX
Practice address
5005 North Piedras St.
El Paso, TX 79920-5001
Phone
(915) 569-1970
Fax
(915) 569-1296
NPI assigned
Nov 4, 2008
Last updated
Apr 28, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 748515 TX Primary

Addresses

Primary practice location

5005 North Piedras St.
El Paso, TX 79920-5001

Mailing address

5005 North Piedras St.
El Paso, TX 79920-5001
Phone (915) 569-1970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090701000448 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163573270 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Ams PLLC CurrentSince Jul 1, 2019 Accepting new patients
Emergenchealth PLLC CurrentSince Jan 2, 2023 Accepting new patients

Locations

1416 George Dieter Dr
El Paso, TX 79936
Phone (877) 822-6281

1815 N Stanton St
El Paso, TX 79902
Phone (915) 533-8412

2900 S Loop 256
Palestine, TX 75801
Phone (903) 731-1021

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1114171154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 NORTH PIEDRAS ST.",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799205001",
            "telephone_number": "915-569-1970",
            "fax_number": "915-569-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 NORTH PIEDRAS ST.",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799205001",
            "telephone_number": "915-569-1970",
            "fax_number": "915-569-1296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "WILLIAM",
        "middle_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-04",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "748515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.