Active NPI
Tracie M Jacobs, APRN
- Family Nurse Practitioner
- Florence, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 29222
- Practice address
- 2437 Willwood Dr
Florence, SC 29501-3904 - Phone
- (843) 777-3100
- NPI assigned
- Aug 9, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 29222 | SC | Primary |
| Registered Nurse | 163W00000X | 259756 | SC |
Addresses
Primary practice location
2437 Willwood Dr
Florence, SC 29501-3904
Mailing address
1349 Fox Hollow Dr
Hartsville, SC 29550-4659
Phone (843) 858-4569
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241023004610 | SC | Practitioner - Nurse Practitioner | 9638602055 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2437 Willwood Dr
Florence, SC 29501-3904
Phone (843) 777-3100
Hospital & facility affiliations
- McLeod Regional Medical Center-Pee Dee
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 259756 | SC | MD | Registered Nurse |
| 29222 | SC | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McLeod Physician Associates II | Current | Accepting new patients | |
| McLeod Physician Associates II | Current | Accepting new patients | |
| McLeod Physician Associates II | Family | Past | Accepting new patients |
Locations
2437 Willwood Dr
Florence, SC 29501
Phone (843) 777-3000
506 E Cheves St
#202
Florence, SC 29506
800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950
800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337
Organizations & group practices 3
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.
-
- Orthopaedic Surgery Physician
- Florence, SC
- NPI 1922555739
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Florence, SC
- NPI 1699756221
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1346923083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1349 FOX HOLLOW DR",
"city": "HARTSVILLE",
"state": "SC",
"postal_code": "295504659",
"telephone_number": "843-858-4569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2437 WILLWOOD DR",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295013904",
"telephone_number": "843-777-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "TRACIE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-09",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "29222",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "259756",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Florence, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.