Jacob C. Parker, DO, MD

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

License

800341120 Issued in MS

Practice address

300 Fairway Dr
Hattiesburg, MS 39401-7715

Phone

(601) 307-5339

NPI assigned

Dec 24, 2018

Reactivated

Jul 20, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 6

Other names 1

• Dr. Christen Daniels Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9778/brand/1/csg/1/fhir/r4

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.

• Epic Systems Corporation Applied Informatics Physician

  • Private Vehicle
  • Honolulu, HI
  • NPI 1568095503
  NPD Authorized official
• Health Facility Laboratory

  • Physiological Laboratory
  • Honolulu, HI
  • NPI 1124585336

  Psychoanalysis

  NPD Authorized official
• Economic Stimulus Act Student Loan Refund 1200 Dollars

  • Pharmacy
  • Hattiesburg, MS
  • NPI 1255999835
  NPD (past) Authorized official
• Forrest Health System

  • Nutrition Support Registered Nurse
  • Birmingham, AL
  • NPI 1619567203

  Single Specialty

  NPD

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

{
    "created_epoch": "1545609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1326510751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FAIRWAY DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017715",
            "telephone_number": "601-329-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FAIRWAY DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017715",
            "telephone_number": "601-307-5339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3301 N Milwaukee St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802054322",
            "country_code": "US",
            "telephone_number": "601-307-8060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "229 Paoakalani Ave # 714",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968153764",
            "country_code": "US",
            "telephone_number": "650-253-0000",
            "fax_number": "650-253-0001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5001 Hardy St # 8",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394021308",
            "country_code": "US",
            "telephone_number": "601-268-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "JACOB",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DO, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-24",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "deactivation_date": "2020-09-22",
        "reactivation_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": "MS",
            "license": "800341120",
            "primary": true
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "IL",
            "license": "8420042213",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "MS",
            "license": "MS80885",
            "primary": false
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "HI",
            "license": "800341120",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA LICENSES",
            "identifier": "251123217211",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7NQ3-KD9-CK19",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800341120",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL LABORATORY IMPROVEMENT AMENDMENTS",
            "identifier": "25187411",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSES",
            "identifier": "MS80885",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "314125401870",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Wikipedia",
            "affiliation": "N",
            "endpointDescription": "Medical research",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "300 Fairway Dr",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394017715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHRISTEN",
            "last_name": "DANIELS",
            "prefix": "DR.",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Scott S Paladichuk, O.D.
• Cheri Papizan, MD
• Eun Park
• Lynley Park
• Amy Parker, PT, DPT, COMT
• Kelly E Parker, MS, CCC/SLP
• Miranda Parker
• Precious Parker
• Regan Rhian Parker, DNP, CRNA
• Renee Parker, RN

• Other Specialist/Technologist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Other Specialist/Technologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.