Jacob Spruill, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95022419 Issued in CA

Practice address

1500 San Pablo St
Los Angeles, CA 90033-5313

Phone

(323) 442-8500

NPI assigned

Oct 28, 2022

Last updated

Aug 8, 2024By 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 CA

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

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Usc Arcadia Hospital Hospital, Arcadia, CA, CCN 050238
• Usc Kenneth Norris Jr Cancer Hospital Hospital, Los Angeles, CA, CCN 050660
• Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306
  Medicare reassignment Care Compare group NPD
• Usc Care Medical Group, Inc

  dba Fair Oaks Clinic

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD

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

• Keck Medical Center of Usc

  dba Keck Hospital of USC

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1013514199
  Care Compare affiliation
• Keck Medical Center of Usc

  dba USC Kenneth Norris Jr. Hospital

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1417554528
  Care Compare affiliation
• Usc Arcadia Hospital

  • General Acute Care Hospital
  • Arcadia, CA
  • NPI 1508851288
  Care Compare affiliation

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

{
    "created_epoch": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1417664582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRUILL",
        "first_name": "JACOB",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-28",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95022419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derrick Sprouse
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• Sprout Wellness Acupuncture, Inc.
• Sprout Wellness Acupuncture, Inc.
• Caelyn Spruiell-Anderson
• Tanissia Sprull
• Sally Ann Spry-Smith, CNM,NP
• Hannah Heininger Spungen, MD, MPH
• Daniel Robert Spurgeon, M.D.
• Ledahlia Spurlock

• Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.

Verify at the official NPI Registry.