Jakob Probst, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-10185 Issued in NC

Practice address

461 Western Blvd Ste 122
Jacksonville, NC 28546-7637

Phone

(910) 333-0283

Fax

(910) 333-0513

NPI assigned

May 26, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Matrix Occupational Health PCGroup PAC ID 2365350220, 42 clinicians

Triad Psychiatric and Counseling Center PAGroup PAC ID 3173590882, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Matrix Occupational Health P.C.

  • Urgent Care Clinic/Center
  • Fayetteville, NC
  • NPI 1144279670
  Medicare reassignment Care Compare group NPD
• Triad Psychiatric and Counseling Center PA

  • Psychiatry Physician
  • Greensboro, NC
  • NPI 1285671602
  Medicare reassignment Care Compare group
• Mediq Urgent Care PC

  • Urgent Care Clinic/Center
  • Greensboro, NC
  • NPI 1912381203
  Medicare reassignment NPD
• Star Medical Clinic PLLC

  • General Practice Physician
  • Jacksonville, NC
  • NPI 1033565007
  Medicare reassignment

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1386267243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 WESTERN BLVD STE 122",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467637",
            "telephone_number": "910-333-0283",
            "fax_number": "910-333-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 WESTERN BLVD STE 122",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467637",
            "telephone_number": "910-333-0283",
            "fax_number": "910-333-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROBST",
        "first_name": "JAKOB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-26",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-10185",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany R Preston
• Price Eye Clinic PA
• Pride in North Carolina, LLC
• Primecare Physicians of Jacksonville, PLLC
• Cynthia Lee Probasco, RN
• Professional Physical Therapy & Rehabilitation, LLC
• Publix North Carolina, LP
• Robert D. Puder, M.D.
• Lisa Pugh, LMBT 7027
• Pulse Transport and Logistics LLC

• Physician Assistant in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.