Suzanne Jacob, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

S8578 Issued in TX

Practice address

2201 Macarthur Dr Ste 103
Waco, TX 76708-3159

Phone

(254) 313-5300

Fax

(254) 313-5399

NPI assigned

May 11, 2017

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Heart of Texas Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Waco, TX
  • NPI 1568191492
  Medicare reassignment NPD
• Heart of Texas Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Waco, TX
  • NPI 1164409926
  NPD
• Heart of Texas Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Temple, TX
  • NPI 1992685218
  NPD
• McLennan County Medical Education and Research Foundation

  • Family Medicine Physician
  • Waco, TX
  • NPI 1689651440
  NPD
• Hillcrest Baptist Medical Center

  • General Acute Care Hospital
  • Waco, TX
  • NPI 1891882833
  NPD (past)

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1255867057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PROVIDENCE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767072261",
            "telephone_number": "254-313-4200",
            "fax_number": "254-313-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 MACARTHUR DR STE 103",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767083159",
            "telephone_number": "254-313-5300",
            "fax_number": "254-313-5399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-2828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SUZANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S8578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Cameron Jackson, CSFA
• Jenise T Jackson, PHLEBOTOMIST
• Roshunda Jackson, LVN
• Shelynbria Jackson
• Stephania Lashawn Jackson
• Michael Lawrence Jahrmarkt, MD
• Avaneesh Jakkoju, M.D
• James K Kavanagh MD PA
• Kyle Douglas James, MD
• Lauren James

• Pediatrics Physician in Waco, TX
• Providers in Waco, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.