Dwayne Aubrey Jacobus, D.P.M.

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

565 Issued in SC

Practice address

3800 N Main St Ste B
Columbia, SC 29203-6446

Phone

(803) 705-3172

Fax

(803) 705-3173

NPI assigned

Oct 31, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in SC, TN2 enrollments

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 2

Specialty

Podiatry

Education

Barry University School of Podiatric Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Footcare, LLCGroup PAC ID 4587748652, 27 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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.

• Physicians Footcare, LLC

  • Foot & Ankle Surgery Podiatrist
  • Columbia, SC
  • NPI 1194909556
  Medicare reassignment Care Compare group NPD
• Eau Claire Cooperative Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1346249430
  Medicare reassignment NPD
• 360Care LLC

  • Dentist
  • Louisville, KY
  • NPI 1417592536

  Podiatrist, SC

  Medicare reassignment NPD
• 360Care LLC

  • Audiologist
  • Columbia, SC
  • NPI 1619598281
  NPD
• Eau Claire Cooperative Health Center ,Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1588375653
  NPD
• Eau Claire Cooperative Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1548571474
  NPD
• Keyoka S Smith DPM LLC

  • Podiatric Clinic/Center
  • Columbia, SC
  • NPI 1164816211
  NPD (past)
• Diabetic Foot Center of Tidewater

  • Foot & Ankle Surgery Podiatrist
  • Norfolk, VA
  • NPI 1306904800
  NPD (past)
• Tidewater Foot & Ankle Center, PC

  • Foot & Ankle Surgery Podiatrist
  • Virginia Beach, VA
  • NPI 1497813158
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1295726172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 LAURELHURST AVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292103825",
            "telephone_number": "803-733-5969",
            "fax_number": "803-753-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 N MAIN ST STE B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036446",
            "telephone_number": "803-705-3172",
            "fax_number": "803-705-3173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Walnut Commons Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385016037",
            "country_code": "US",
            "telephone_number": "931-528-1331",
            "fax_number": "931-528-6893",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 W Cheves St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "SC",
            "postal_code": "295014448",
            "country_code": "US",
            "telephone_number": "843-679-9090",
            "fax_number": "843-679-9080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBUS",
        "first_name": "DWAYNE",
        "middle_name": "AUBREY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2023-03-07",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SC",
            "license": "565",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "847",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "TN",
            "license": "847",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "TN",
            "license": "847",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "SC",
            "license": "565",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "SC",
            "license": "565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TN",
            "identifier": "T14910A",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD5658",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q058390",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vernetta H Jacobs, MD
• Elena J Jacobson, PA-C
• Erin Teal Jacobson, PT
• Jessica Mullis Jacobson
• Leah Renate Jacobson, CD DONA
• Richard West Jacocks, PHARMD
• Jacqueline Allen Primary Care LLC
• Terrill D Jacques, CPSS
• Jacquette Caldwell MD PA
• Jade Bloom Psychoeducational Services LLC

• Primary Podiatric Medicine Podiatrist in Columbia, SC
• Providers in Columbia, SC by specialty
• Primary Podiatric Medicine Podiatrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.