Kelly D Jacobs, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

234723 Issued in LA

Practice address

1921 Kaliste Saloom Rd Ste 117
Lafayette, LA 70508-6183

Phone

(337) 210-5827

NPI assigned

Jun 10, 2024

Last updated

Jun 10, 2024By the provider in NPPES

Sex

Female

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 LA

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Willow Total Health LLCGroup PAC ID 9830690874, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Womans Hospital Hospital, Baton Rouge, LA, CCN 190128

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacobs-kelly@a4f19d98.micromddirect.com

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.

• NP Mom LLC

  • Nurse Practitioner
  • Lafayette, LA
  • NPI 1467283184
  Medicare reassignment NPD Authorized official
• Willow Total Health LLC

  • Family Nurse Practitioner
  • Broussard, LA
  • NPI 1255131413
  Medicare reassignment Care Compare group NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  LA, Nurse Practitioner

  Medicare reassignment NPD
• Broussard Mental Health and Wellness Clinic LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Broussard, LA
  • NPI 1982596789
  NPD

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

• Woman's Hospital Foundation

  dba Woman's Hospital

  • General Acute Care Hospital
  • Baton Rouge, LA
  • NPI 1912943184
  Care Compare affiliation

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1447092630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 KALISTE SALOOM RD STE 117",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086183",
            "telephone_number": "337-210-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 KALISTE SALOOM RD STE 117",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086183",
            "telephone_number": "337-210-5827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "KELLY",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "234723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob L Breaux, MD, LLC
• Jacob R Karr, MD, LLC
• Jerome Jacob Jr.
• April E Jacobs, LPC
• Dwayne Jacobs, LPC, 6090
• Leslie J Jacobs, DDS
• Sheresa Jacobs
• Taylor McHugh Jacobs, MS, CCC-SLP
• Donald Scott Jacobsen, OD
• Jacque F. Noel, III, M.D.

• Family Nurse Practitioner in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.