Wilbert Clifton Jacobs II, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MMD.32701LL Issued in SC

Practice address

1990 N Prospect Ave
Lecanto, FL 34461-9792

Phone

(352) 527-6888

NPI assigned

Jun 9, 2010

Last updated

Oct 14, 2021By the provider in NPPES

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Family Practice

Education

Medical University of South Carolina College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suncoast Community Health Centers IncGroup PAC ID 3870402548, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Dynamic Primary Healthcare Clinic

  • Family Medicine Physician
  • Lake City, FL
  • NPI 1710633144

  Corporate Director

  CMS ownership

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.

• Suncoast Community Health Centers Inc

  dba Ruskin Health Center

  • Federally Qualified Health Center (FQHC)
  • Ruskin, FL
  • NPI 1285644799
  Medicare reassignment Care Compare group NPD
• Suncoast Community Health Centers, Inc

  dba Wimauma Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Wimauma, FL
  • NPI 1518388354
  NPD
• Suncoast Community Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Ruskin, FL
  • NPI 1104836600

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1124348438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2066",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344602066",
            "telephone_number": "352-527-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 N PROSPECT AVE",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344619792",
            "telephone_number": "352-527-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "WILBERT",
        "middle_name": "CLIFTON",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-09",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "MMD.32701LL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009947600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lee Elma Howell Jr., M.D.
• HRS Citrus County Health Dept. Pharmacy
• Htcitrus LLC
• Integrated Regional Laboratories Pathology Services, LLC
• Interim Healthcare Private Services, Inc. (Interim HealthCare)
• Jeff Moser Inc
• Shelby Miller Jenkins, PA
• Mary Jensen
• Coleen Dodson Jeter, PT
• Jmjmbhandy LLC

• Family Medicine Physician in Lecanto, FL
• Providers in Lecanto, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.