NPIMap

Individual provider Active NPI

Gregorio Jacob, M.D.

  • Specialist
  • Goldsboro, NC
National Provider Identifier
1558325811
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9501287 Issued in NC
Practice address
2704 Medical Office PL
Goldsboro, NC 27534-9460
Phone
(919) 736-4724
Fax
(919) 736-1677
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9501287 NC Primary

Addresses

Primary practice location

2704 Medical Office PL
Goldsboro, NC 27534-9460

Mailing address

2704 Medical Office PL
Goldsboro, NC 27534-9460
Phone (919) 736-4724

Other identifiers 2

IdentifierTypeStateIssuer
4568COtherNCBCBS
894568CMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040520001546 NC Practitioner - Internal Medicine 5092706788 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
May accept Medicare assignment
Group practices
Eventus Wholehealth PLLCGroup PAC ID 6002169539, 301 clinicians
Eventus WH Southeast, LLCGroup PAC ID 5496294456, 241 clinicians

Practice addresses (Care Compare)

101 Cabarrus Ave E
Suite 200
Concord, NC 28025-3781
Phone (855) 743-2247

212 S Tryon St
Suite 1000
Charlotte, NC 28281-0006
Phone (855) 743-2247

Hospital & facility affiliations

  • Lower Cape Fear Lifecare Hospice, Wilmington, NC, CCN 341515
  • Unc Lenoir Health Care Hospital, Kinston, NC, CCN 340027
  • Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141
  • Premier Living and Rehab Center Nursing home, Lake Waccamaw, NC, CCN 345185
  • NC State Veterans Home-Kinston Nursing home, Kinston, NC, CCN 345560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Eventus Wholehealth Aco LLC CurrentSince Aug 1, 2024 Accepting new patients
Eventus Wholehealth, PLLC CurrentSince Dec 5, 2022 Accepting new patients
Eventus WH PLLC Care, LLC CurrentSince Sep 1, 2025 Accepting new patients
Eventus Value Care, LLC CurrentSince Dec 5, 2022 Accepting new patients
Eventus WH Southeast, LLC CurrentSince Jan 1, 2025 Accepting new patients
Bluebell Health & Wellness, PLLC PastSince Dec 7, 2021 Accepting new patients
Rocky Mount Health and Rehabilitation, LLC Past Accepting new patients
Our Community Hospital, Inc Past Accepting new patients
Premier Living and Rehab Center Past Accepting new patients

Locations

2810 Coliseum Centre Dr
Ste 120
Charlotte, NC 28217

212 S Tryon St
Ste 1000
Charlotte, NC 28281
Phone (512) 575-8028

160 Mine Lake Ct
#200
Raleigh, NC 27615
Phone (404) 805-4288

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1558325811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349460",
            "telephone_number": "919-736-4724",
            "fax_number": "919-736-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349460",
            "telephone_number": "919-736-4724",
            "fax_number": "919-736-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "GREGORIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "9501287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4568C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "894568C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

Verify at the official NPI Registry.