Stacey L Jacobs, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71004631B Issued in IN

Practice address

1319 Duncan Ave
Jeffersonville, IN 47130-3759

Phone

(812) 283-2308

Fax

(812) 283-2832

NPI assigned

Sep 25, 2013

Sex

Female

Sole proprietor

Yes

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 IN, KY2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Health Center of Clark County, IncGroup PAC ID 8426139254, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Norton Clark Hospital Hospital, Jeffersonville, IN, CCN 150009
• Harrison County Hospital Hospital, Corydon, IN, CCN 151331

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Family Health Center of Clark County, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jeffersonville, IN
  • NPI 1528125341
  Medicare reassignment Care Compare group NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  KY, Nurse Practitioner

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Harrison County Hospital

  • Ambulance
  • Corydon, IN
  • NPI 1073620001

  Hospital

  Care Compare affiliation
• Harrison County Hospital

  • General Acute Care Hospital
  • Corydon, IN
  • NPI 1427165455
  Care Compare affiliation
• Harrison County Hospital

  • Ambulance
  • Corydon, IN
  • NPI 1760599468

  Hospital

  Care Compare affiliation
• Harrison County Hospital

  • Critical Access Hospital
  • Corydon, IN
  • NPI 1851378137
  Care Compare affiliation
• Norton Clark Hospital, LLC

  • General Acute Care Hospital
  • Jeffersonville, IN
  • NPI 1134186315
  Care Compare affiliation

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1295161933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 DUNCAN AVE",
            "address_2": "FAMILY HEALTH CENTER CLARK COUNTY",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303759",
            "telephone_number": "812-283-2308",
            "fax_number": "812-283-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 DUNCAN AVE",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303759",
            "telephone_number": "812-283-2308",
            "fax_number": "812-283-2832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 Wellington Way Ste 330",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405031331",
            "country_code": "US",
            "telephone_number": "859-439-0400",
            "fax_number": "859-439-0399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "STACEY",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2022-10-11",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "3010254",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71004631B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda J Jackson, APRN
• Brianna Jackson, RBT
• Jada Jackson, RBT
• Noah Jackson, RBT
• Joseph W. Jacobi, DDS
• Jacquelyn Bainbridge
• Eric Jaggers, MD
• James Patrick Murphy MD PSC
• James R Davis MD LLC
• Arese F James, LCSW

• Nurse Practitioner in Jeffersonville, IN
• Providers in Jeffersonville, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.