Individual provider Active NPI

Robert R. Jacobs, D.O.

  • Emergency Medicine Physician
  • El Dorado, AR
National Provider Identifier
1558347286
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E-2641 Issued in AR
Practice address
700 W Grove St
El Dorado, AR 71730-4416
Phone
(870) 863-2200
Fax
(870) 864-0202
NPI assigned
Dec 15, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-2641 AR Primary

Addresses

Primary practice location

700 W Grove St
El Dorado, AR 71730-4416

Mailing address

778 Scogin Dr
Monticello, AR 71655-5729
Phone (870) 367-2411

Other identifiers 1

IdentifierTypeStateIssuer
5L634OtherARBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20041025000276 AR Practitioner - Family PracticePractitioner - Emergency Medicine 1254392178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monticello Ess LLCGroup PAC ID 4880914639, 10 clinicians

Practice addresses (Care Compare)

778 Scogin Dr
Monticello, AR 71655-5729
Phone (870) 367-2411

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Monticello Ess LLC Emergency Medicine CurrentSince May 1, 2015 Accepting new patients
Arkansas Emergency Staffing Solutions, Inc Emergency Medicine CurrentSince May 15, 2009 Accepting new patients
Nes Arkansas, Inc. Emergency Medicine Past Accepting new patients
McGehee Desha County Hospital Past Accepting new patients

Locations

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

778 Scogin Dr
Monticello, AR 71655
Phone (870) 367-2411

Organizations & group practices 4

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 1

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558347286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "778 SCOGIN DR",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716555729",
            "telephone_number": "870-367-2411",
            "fax_number": "870-460-3562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W GROVE ST",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304416",
            "telephone_number": "870-863-2200",
            "fax_number": "870-864-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "ROBERT",
        "middle_name": "R.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-2641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5L634",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

Verify at the official NPI Registry.