Individual provider Active NPI

Jacob Robert Erfurth, DO

  • Emergency Medicine Physician
  • Clarksville, TN
National Provider Identifier
1619506086
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4995 Issued in TN
Practice address
651 Dunlop LN
Clarksville, TN 37040-5015
Phone
(931) 502-3750
NPI assigned
Apr 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS19173 FL
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 4995 TN Primary

Addresses

Primary practice location

651 Dunlop LN
Clarksville, TN 37040-5015

Mailing address

1960 Madison St Ste J206
Clarksville, TN 37043-8063
Phone (608) 341-9641

Other practice location 1

11375 Cortez Blvd
Brooksville, FL 34613-5409
Phone (352) 592-2757

Other practice location 2

13670 Walsingham Rd
Largo, FL 33774-3532
Phone (727) 593-9848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN2 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

Enrollment IDStateProvider typePAC IDDetails
I20220928001167 FL Practitioner - Emergency Medicine 0547646523 Reassigns benefits to 2 organizations
I20230522001790 TN Practitioner - Emergency Medicine 0547646523 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Sep 16, 2022 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Jul 26, 2023 Accepting new patients
Middle Tennessee Emergency Physicians PC Emergency Medicine CurrentSince Oct 1, 2023 Accepting new patients
App of Tennessee Ed, PLLC Emergency Medicine CurrentSince May 1, 2023 Accepting new patients
Baycare Medical Group, Inc. Current Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

13670 Walsingham Rd
Largo, FL 33774
Phone (727) 593-9848

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

106 Medical Center Blvd
Fayetteville, TN 37334
Phone (931) 438-1100

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

1559 Sparta St
McMinnville, TN 37110
Phone (615) 406-9544

2000 Church St
Nashville, TN 37236
Phone (615) 284-4672

520 W Main St
Smithville, TN 37166
Phone (615) 215-5000

401 Sewell Dr
Sparta, TN 38583
Phone (931) 738-2164

324 Doolittle Rd
Woodbury, TN 37190
Phone (615) 563-4001

Networks

  • Optimum HealthCare HMO Network

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1619506086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 MADISON ST STE J206",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438063",
            "telephone_number": "608-341-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 DUNLOP LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405015",
            "telephone_number": "931-502-3750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11375 Cortez Blvd",
            "address_purpose": "LOCATION",
            "city": "Brooksville",
            "state": "FL",
            "postal_code": "346135409",
            "country_code": "US",
            "telephone_number": "352-592-2757",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13670 Walsingham Rd",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "337743532",
            "country_code": "US",
            "telephone_number": "727-593-9848",
            "fax_number": "727-596-4532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERFURTH",
        "first_name": "JACOB",
        "middle_name": "ROBERT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS19173",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "4995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.