Active NPI
Latha Jacob, NP
- Nurse Practitioner
- Addison, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 739362
- Practice address
- 14131 Midway Road
Suite 620
Addison, TX 75001-3669 - Phone
- (972) 249-0200
- Fax
- (972) 249-0206
- NPI assigned
- Sep 23, 2011
- Sex
- Female
- Sole proprietor
- No
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.
-
- Hospitalist Physician
- Addison, TX
- NPI 1194174201
Nurse Practitioner, TX
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Plano, TX
- NPI 1235168345
-
- Home Health Agency
- Allen, TX
- NPI 1851361166
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- NV Pacs 2 LLCIpc Pac Healthcare Services of Texas PLLC
Practice addresses (Care Compare)
2680 Legacy Dr
Frisco, TX 75034-6064
Phone (469) 362-1313
6211 S New Braunfels Ave
The Rio at Mission Trails TX
San Antonio, TX 78223-3175
Phone (210) 531-0569
999 Raintree Cir
Allen, TX 75013-4947
Phone (972) 390-8088
Hospital & facility affiliations
- Enhabit Home Health
- Reliant at Home
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.72 of 100
- Quality
- 72.97
- Improvement activities
- 40
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111118000471 | TX | Practitioner - Nurse Practitioner | 8022282532 | Reassigns benefits to 3 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CS Pacs 3 Southwest, LLC | Current | Accepting new patients | |
| NV Pacs 2 LLC | Current | Accepting new patients | |
| Ipc Pac Healthcare Services of Texas PLLC | Nurse Practitioner | Current | Accepting new patients |
Locations
14131 Midway Rd
Ste 620
Addison, TX 75001
Phone (972) 249-0200
999 Raintree Cir
Allen, TX 75013
Phone (972) 390-8088
201 Sycamore School Rd
#R
Fort Worth, TX 76134
Phone (817) 293-7610
6301 Oakmont Blvd
Ft Worth, TX 76132
Phone (682) 250-4055
415 Indian Oaks Dr
Harker Hts, TX 76548
Phone (254) 699-5051
721 W Mulberry St
Holiday Lakes, TX 77515
Phone (979) 848-0279
2101 W Northgate Dr
Irving, TX 75062
Phone (972) 255-4460
208 S Utah St
La Porte, TX 77571
Phone (281) 471-1810
811 Garner Rd
Pasadena, TX 77502
Phone (713) 473-0687
6800 Preston Rd
Plano, TX 75024
Phone (214) 473-3634
6211 S New Braunfels Ave
#T
San Antonio, TX 78223
Phone (210) 531-0569
7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564
424 Tarpey Rd
#C
Texas City, TX 77591
Phone (409) 938-8431
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 739362 | TX | Primary |
| Rehabilitation Registered Nurse | 163WR0400X | 739362 | TX |
Addresses
NPPES NPI RegistryPrimary practice location
14131 Midway Road
Suite 620
Addison, TX 75001-3669
Mailing address
14131 Midway Road
Suite 620
Addison, TX 75001-3669
Phone (972) 249-0200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 17, 2013.
{
"created_epoch": "1316736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366156800000",
"number": "1376826503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14131 MIDWAY ROAD",
"address_2": "SUITE 620",
"city": "ADDISON",
"state": "TX",
"postal_code": "750013669",
"telephone_number": "972-249-0200",
"fax_number": "972-249-0206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14131 MIDWAY ROAD",
"address_2": "SUITE 620",
"city": "ADDISON",
"state": "TX",
"postal_code": "750013669",
"telephone_number": "972-249-0200",
"fax_number": "972-249-0206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "LATHA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-23",
"last_updated": "2013-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "739362",
"primary": true
},
{
"code": "163WR0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Rehabilitation",
"state": "TX",
"license": "739362",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Addison, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.