Mary Deena Jacob, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP138925 Issued in TX

Practice address

411 E McDermott Dr Ste a
Allen, TX 75002-2854

Phone

(972) 227-3464

NPI assigned

Mar 5, 2019

Last updated

Feb 22, 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 TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Aymancare PLLC

  • Multi-Specialty Clinic/Center
  • North Richland Hills, TX
  • NPI 1861955395
  Medicare reassignment
• Khan Healthcare Services PLLC

  dba Ayman Urgent Care

  • Urgent Care Clinic/Center
  • North Richland Hills, TX
  • NPI 1629635792
  NPD (past)

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1518425982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109,BURNET DRIVE",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "75002",
            "telephone_number": "214-901-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E MCDERMOTT DR STE A",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750022854",
            "telephone_number": "972-227-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "MARY",
        "middle_name": "DEENA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jabari Healthcare LLC
• Ashley Marisa Jackson, ATC
• Jerrica A Jackson
• Marita Cecilia Jackson, LVN
• Linda Jacob, DDS
• Rosy Julie Jacob, FNP-C
• Kimberlyn Jaggers
• Rohan Deepak Jagtap, DMD, MS, OMFR, BDS
• Masuma J Jahangir, RPH
• Sonal Jain, M.D.

• Family Nurse Practitioner in Allen, TX
• Providers in Allen, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.