Deloris M Jacobs, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3004861 Issued in KY

Practice address

2608 Ring Road
Ste B107
Elizabethtown, KY 42701

Phone

(270) 506-3741

Fax

(270) 506-3768

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cumberland Family Medical Center IncGroup PAC ID 6305947789, 125 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Baptist Health Medical Group Inc

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1922401611

  KY, Nurse Practitioner

  Medicare reassignment NPD
• Cumberland Family Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Burkesville, KY
  • NPI 1306873500

  KY

  Medicare reassignment NPD
• Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  NPD
• Cumberland Family Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Edmonton, KY
  • NPI 1548953672
  NPD
• Cumberland Family Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Frankfort, KY
  • NPI 1376115808
  NPD (past)
• Discover Recovery, LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Elizabethtown, KY
  • NPI 1326671637
  NPD (past)
• James Moss PLLC

  • Family Medicine Physician
  • Elizabethtown, KY
  • NPI 1932492733

  Nurse Practitioner

  NPD (past)
• Primary Care @ Home, LLC

  • Family Medicine Physician
  • Elizabethtown, KY
  • NPI 1003137605

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1154460467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 RING ROAD",
            "address_2": "STE B107",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "42701",
            "telephone_number": "270-506-3741",
            "fax_number": "270-506-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "DELORIS",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2023-08-25",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4861P",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3004861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11716456",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100144180",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Thomas Jackson, CSFA
• Thad Jackson, MD
• Velma J. Jackson, CADC
• Jacob Schultz Rehabilitation Services
• Cynthia O Jacobi, LPCC
• Wendy Jacoby, TCM
• Amy Marie Jaggers
• Mary Jaggers
• Nicole C Jaggers
• Timothy Wyatt Jaggers, PHARMD

• All providers in Elizabethtown, KY
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.