Individual provider Active NPI

Amanda Collins Jacobs, FNP

  • Family Nurse Practitioner
  • Laurinburg, NC
National Provider Identifier
1437916848
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5019711 Issued in NC
Practice address
705B Lauchwood Dr
Laurinburg, NC 28352-5544
Phone
(910) 610-4278
NPI assigned
Mar 1, 2024
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5019711 NC Primary

Addresses

Primary practice location

705B Lauchwood Dr
Laurinburg, NC 28352-5544

Mailing address

6813 US Highway 74 W
Rowland, NC 28383-9031
Phone (910) 301-1450

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240501000093 NC Practitioner - Nurse Practitioner 2567802010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scotland Memorial Hospital, IncGroup PAC ID 0648208504, 259 clinicians
MCPC-5 LLCGroup PAC ID 4284881012, 31 clinicians

Practice addresses (Care Compare)

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (910) 610-4172

705 B Lauchwood Dr
Laurinburg, NC 28352-5544
Phone (910) 610-4278

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5019711NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scotland Memorial Hospital Inc CurrentSince Apr 1, 2024 Accepting new patients
Scotland Memorial Hospital Inc CurrentSince Apr 1, 2024 Accepting new patients
MCPC-5, LLC CurrentSince Apr 1, 2024 Accepting new patients
MCPC-5, LLC CurrentSince Apr 1, 2024 Accepting new patients
MCPC-5, LLC Current Accepting new patients

Locations

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

705B Lauchwood Dr
Laurinburg, NC 28352
Phone (910) 266-0111

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

Interoperability endpoints

  • Direct secure messaging: ajacobs119592@firsthealth.direct-ci.net

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1437916848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6813 US HIGHWAY 74 W",
            "city": "ROWLAND",
            "state": "NC",
            "postal_code": "283839031",
            "telephone_number": "910-301-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705B LAUCHWOOD DR",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525544",
            "telephone_number": "910-610-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "AMANDA",
        "middle_name": "COLLINS",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5019711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurinburg, NC

Sources for this page

Verify at the official NPI Registry.