Jacqueline H Grant, MD, MPH, MPA
Individual provider Active NPI Maternal & Fetal Medicine Physician · Columbus, GA
NPI 1124189600 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1124189600
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Maternal & Fetal Medicine Physician 207VM0101X
- License
- 032570 (GA)
- Practice address
- 2000 10TH Ave Ste 100
Columbus, GA 31901-3703 - Phone
- (706) 571-1285
- NPI assigned
- Dec 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 31
Medicare Care Compare profile
- 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 Group
Saint Francis Medical Center
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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040819000383 | MO | Practitioner - Obstetrics/Gynecology | 9436122157 | Reassigns benefits to 2 organizations |
| I20240429000316 | IL | Practitioner - Obstetrics/Gynecology | 9436122157 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Francis Medical Center | Multi-Specialty | Current |
Accepting new patients |
| Saint Francis Medical Center | Current |
Accepting new patients | |
| SSM Health Care Group | Multi-Specialty | Current |
Accepting new patients |
| SSM Health Care St Louis | Multi-Specialty | Current |
Accepting new patients |
| SSM Health Care St. Louis | Multi-Specialty | Current |
Accepting new patients |
| SSM Health Care Group | Multi-Specialty | Current |
Accepting new patients |
| Saint Francis Medical Center | Multi-Specialty | Current | Accepting new patients |
| Morehouse Healthcare, Inc. | Multi-Specialty | Past |
Accepting new patients |
| Worth County Board of Health | Past |
Accepting new patients | |
| Columbus Ambulatory Healthcare Services, Inc. | Multi-Specialty | Past | Accepting new patients |
| Lee County Board of Health | Past |
Accepting new patients | |
| Decatur County Board of Health | Past |
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
1031 Bellevue Ave
Ste 400
Saint Louis, MO 63117
10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647
Interoperability endpoints
- jgrant455794@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Maternal & Fetal Medicine Physician |
207VM0101X | 2015-00684 | NC | |
| Maternal & Fetal Medicine Physician | 207VM0101X | 032570 | GA | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 695415663A | Medicaid | GA |
Other providers in Columbus, GA
- Yasmin Jacole Graham
- Kevin Joel Grajales
- Alyssa Grant
- Connie Grant
- Hannah Elisabeth Grant
- Patrick S Grant Sr.
- Shatara Grant
- Tiffaney Nicole Grant
- Amy Joyce Grasman
- Chioma Graves
All providers in Columbus, GA · Maternal & Fetal Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.