Individual provider Active NPI

Jacqueline H Grant, MD, MPH, MPA

  • Maternal & Fetal Medicine Physician
  • Columbus, GA
National Provider Identifier
1124189600
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
032570 Issued in GA
Practice address
2000 10TH Ave Ste 100
Columbus, GA 31901-3703
Phone
(706) 571-1285
NPI assigned
Dec 12, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VM0101X 2015-00684 NC
Maternal & Fetal Medicine Physician 207VM0101X 032570 GA Primary

Addresses

Primary practice location

2000 10TH Ave Ste 100
Columbus, GA 31901-3703

Mailing address

Unc Department of Obstetrics and Gynecology
3010 Old Clinic Building CB # 7516
Chapel Hill, NC 27599-7516
Phone (919) 966-6444

Other practice location 1

Unc Hospitals and Clinics 101 Manning Dr
Chapel Hill, NC 27599-0001
Phone (919) 966-6444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040819000383 MO Practitioner - Obstetrics/Gynecology 9436122157 Reassigns benefits to 2 organizations
I20240429000316 IL Practitioner - Obstetrics/Gynecology 9436122157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Morehouse School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

1031 Bellevue Ave
Suite 400
Saint Louis, MO 63117-1858
Phone (314) 977-7455

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Phone (573) 331-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
032570GAMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St Louis Multi-Specialty CurrentSince Feb 11, 2024 Accepting new patients
SSM Health Care Group Multi-Specialty CurrentSince Jul 1, 2023 Accepting new patients
Saint Francis Medical Center Multi-Specialty Current Accepting new patients
SSM Health Care St. Louis Multi-Specialty CurrentSince Feb 11, 2024 Accepting new patients
Saint Francis Medical Center Multi-Specialty CurrentSince Nov 5, 2025 Accepting new patients
SSM Health Care Group Multi-Specialty CurrentSince Jul 1, 2023 Accepting new patients
Saint Francis Medical Center CurrentSince Nov 5, 2025 Accepting new patients
Lee County Board of Health PastSince May 1, 1993 Accepting new patients
Ferguson Medical Group Rural Health Center Inc. Multi-Specialty Past Accepting new patients
Decatur County Board of Health PastSince May 1, 1993 Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. Multi-Specialty Past Accepting new patients
Morehouse Healthcare, Inc. Multi-Specialty PastSince Jul 1, 2012 Accepting new patients
Worth County Board of Health PastSince May 1, 1993 Accepting new patients

Locations

900 E Walnut St
Ste 5
Carbondale, IL 62901
Phone (618) 519-9182

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1191 Fortune Blvd
Ste 1
Shiloh, IL 62269
Phone (618) 206-6101

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1031 Bellevue Ave
Ste 400
Saint Louis, MO 63117

Interoperability endpoints

  • Direct secure messaging: jgrant455794@direct-ehr-ssmhc.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1124189600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNC DEPARTMENT OF OBSTETRICS AND GYNECOLOGY",
            "address_2": "3010 OLD CLINIC BUILDING CB # 7516",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997516",
            "telephone_number": "919-966-6444",
            "fax_number": "919-966-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 10TH AVE STE 100",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319013703",
            "telephone_number": "706-571-1285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Unc Hospitals and Clinics 101 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275990001",
            "country_code": "US",
            "telephone_number": "919-966-6444",
            "fax_number": "919-966-6377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "JACQUELINE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD, MPH, MPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NC",
            "license": "2015-00684",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "GA",
            "license": "032570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.