Jacob Manaloor Abraham, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

085757 Issued in GA

Practice address

200 Doctors Dr Ste K
Douglas, GA 31533-2202

Phone

(912) 384-4024

NPI assigned

Jun 24, 2017

Last updated

Feb 6, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 WV, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wayne SJC Medical Group LLCGroup PAC ID 5496901811, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Home Care Home health agency, Jesup, GA, CCN 117012
• Centerwell Home Health Home health agency, Brunswick, GA, CCN 117144
• Georgia Hospice Care Hospice, Jesup, GA, CCN 111760
• Wayne Memorial Hospital Hospital, Jesup, GA, CCN 110124
• Coffee Regional Medical Center, Inc Hospital, Douglas, GA, CCN 110089

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GDDICA

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.

• Wayne SJC Medical Group, LLC

  • Otolaryngology Physician
  • Jesup, GA
  • NPI 1538421177

  Family Medicine

  Medicare reassignment Care Compare group NPD
• CRH Physician Practices, LLC

  dba CRH Pain Management

  • Multi-Specialty Clinic/Center
  • Douglas, GA
  • NPI 1710046073
  Medicare reassignment NPD
• Community Health Systems, Inc.

  dba Access Health

  • Federally Qualified Health Center (FQHC)
  • Beckley, WV
  • NPI 1588738538
  Medicare reassignment NPD
• Wayne SJC Medical Group, LLC

  • Orthopaedic Surgery Physician
  • Jesup, GA
  • NPI 1851730626
  NPD
• Community Health Systems Inc

  dba AccessHealth Professional Park 2

  • Federally Qualified Health Center (FQHC)
  • Beckley, WV
  • NPI 1194510644
  NPD

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

• Centerwell Health Services USA, LLC

  dba CenterWell Home Health

  • Home Health Agency
  • Brunswick, GA
  • NPI 1619959251
  Care Compare affiliation
• Coffee Regional Medical Center, Inc

  dba Coffee Regional Medical Center

  • General Acute Care Hospital
  • Douglas, GA
  • NPI 1760419527
  Care Compare affiliation
• GHC-Jesup, LLC

  dba GHC Hospice

  • Community Based Hospice Care Agency
  • Jesup, GA
  • NPI 1831597616
  Care Compare affiliation
• Hospital Authority of Wayne County Georgia

  dba Community Home Care

  • Home Health Agency
  • Jesup, GA
  • NPI 1699779405
  Care Compare affiliation
• Hospital Authority of Wayne County, Georgia

  dba wayne memorial hospital

  • General Acute Care Hospital
  • Jesup, GA
  • NPI 1770578999
  Care Compare affiliation

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

{
    "created_epoch": "1498262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1528588142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1377",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315341377",
            "telephone_number": "912-384-1477",
            "fax_number": "912-384-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR STE K",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332202",
            "telephone_number": "912-384-4024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Memorial Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Jesup",
            "state": "GA",
            "postal_code": "315450134",
            "country_code": "US",
            "telephone_number": "912-559-2337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "JACOB",
        "middle_name": "MANALOOR",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-24",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101023560",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "085757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Miller Family Medicine Inc.
• Air Evac EMS Inc. (Air Evac Lifeteam)
• Alignpro Chiropractic LLC
• Brandie Altman, M.ED CCC-SLP
• Amedisys Georgia, LLC (Amedisys Home Health)
• Americanwork, LLC (Clarvida)

• Family Medicine Physician in Douglas, GA
• Providers in Douglas, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.