Paul Christopher Jacobs, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

046007399 Issued in IL

Practice address

1001 N Beadle Dr
Suite 40
Carbondale, IL 62901-1018

Phone

(618) 529-4817

Fax

(618) 351-9024

NPI assigned

Sep 13, 2005

Last updated

Aug 9, 2013By 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 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Merriman Optometry, LTDGroup PAC ID 1951774686, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Merriman Optometry, LTD

  dba Eyedeal Eyecare

  • Optometrist
  • Anna, IL
  • NPI 1033826524
  Medicare reassignment Care Compare group NPD
• Crabtree Family Optometry

  dba Crabtree and Merriman Optometry

  • Corneal and Contact Management Optometrist
  • Marion, IL
  • NPI 1609072263
  Medicare reassignment
• Crabtree and Merriman Dctrs of Optometry

  dba Jacobs & Crabtree Dctrs of Optometry

  • Corneal and Contact Management Optometrist
  • Carbondale, IL
  • NPI 1558352641
  Authorized official Same address or phone

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1255326500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N BEADLE DR",
            "address_2": "SUITE 40",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011018",
            "telephone_number": "618-529-4817",
            "fax_number": "618-351-9024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N BEADLE DR",
            "address_2": "SUITE 40",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011018",
            "telephone_number": "618-529-4817",
            "fax_number": "618-351-9024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "PAUL",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "046007399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "410002083",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "410048999",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam J Jackson
• Johnathan Jackson, BS
• Laneasze C Jackson
• Turkessa Crystal Jackson, MA, CRC, LCPC
• Chantel Jacobs
• Julie Elaine Jacobson
• Ahmed H Jafri, M.D.
• Michael James, FNP-BC
• Rachel Ann Jarvis, MA
• Angela M Jenkins

• Corneal and Contact Management Optometrist in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Corneal and Contact Management Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.