Richard Keith Jacob Jr., MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

58881 Issued in GA

Practice address

2151 W Spring St Ste B210
Monroe, GA 30655

Phone

(770) 207-5738

Fax

(770) 266-7346

NPI assigned

Mar 19, 2007

Last updated

Mar 19, 2025By 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

Medicare fee-for-service enrollment

Enrolled in NC, GA2 enrollments

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 2

Specialty

General Surgery

Education

Texas Tech University Health Science Center School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Walton Hospital Hospital, Monroe, GA, CCN 110046

Merit-based Incentive Payment System (MIPS)

Final score

91.62 of 100Reported as apm

Quality

83.25

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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

• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  Medicare reassignment Care Compare group
• Scotland Memorial Hospital Inc

  dba SURGICAL ASSOCIATES of SCOTLAND

  • Vascular Surgery Physician
  • Laurinburg, NC
  • NPI 1477791507
  Medicare reassignment NPD
• Scotland Memorial Hospital Inc

  dba Sterling Surgical Services

  • Surgery Physician
  • Laurinburg, NC
  • NPI 1104918754
  NPD
• Piedmont Medical Care Corporation

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1912956046
  NPD (past)

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

• Piedmont Walton Hospital Inc

  • General Acute Care Hospital
  • Monroe, GA
  • NPI 1720589328
  Care Compare affiliation

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1316061179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 W SPRING ST STE B210",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306553214",
            "telephone_number": "770-207-5738",
            "fax_number": "770-266-7346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 W SPRING ST STE B210",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "30655",
            "telephone_number": "770-207-5738",
            "fax_number": "770-266-7346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "RICHARD",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "58881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independent Physical Therapy of Georgia, LLC (BenchMark PT)
• Irad, Inc.
• Iwcga Monroe LLC
• Grace Ann Jackson
• Ledasha Jackson, MS
• James E Dubose DMD PC
• Bhavin H Jani, MD
• Gerald Pierre Jean, NURSE PRACTITIONER
• Jeff Cohenour, MD, PC
• Jamie Jenkins

• Surgery Physician in Monroe, GA
• Providers in Monroe, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.