NPIMap

Individual provider Active NPI

William Carl Jacobs Jr., M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Charlotte, NC
National Provider Identifier
1639317308
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
2011-01022 Issued in NC
Practice address
1000 Blythe Blvd FL 4
Charlotte, NC 28203-5812
Phone
(704) 973-5500
NPI assigned
Feb 3, 2009
Last updated
Apr 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 34271 SC
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2011-01022 NC Primary

Addresses

Primary practice location

1000 Blythe Blvd FL 4
Charlotte, NC 28203-5812

Mailing address

PO Box 30637
Charlotte, NC 28230-0637
Phone (704) 973-2497

Other identifiers 2

IdentifierTypeStateIssuer
34271OtherSCSTATE MEDICAL LICENSE
2011-01022OtherNCSTATE MEDICAL LICENSE

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
I20110726000093 NC Practitioner - Pathology 7517135148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Medical College of Georgia School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Pathology Group PAGroup PAC ID 3375529985, 50 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2251

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-0611

600 Hospital Dr
Monroe, NC 28112-6000
Phone (980) 993-4131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34271SCMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Pathology Group, PA CurrentSince Jul 1, 2011 Accepting new patients
Carolinas Pathology Group, PA Anatomic Pathology & Clinical Pathology PastSince Nov 24, 2024 Accepting new patients

Locations

301 Yadkin St
Albemarle, NC 28001
Phone (704) 984-4000

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1000 Blythe Blvd
Fl 4
Charlotte, NC 28203
Phone (704) 355-8188

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

5040 Airport Center Pkwy
Charlotte, NC 28208
Phone (704) 446-4490

6135 Lakeview Rd
Ste 350
Charlotte, NC 28269
Phone (704) 549-8444

180 Parkwood Dr
Elkin, NC 28621
Phone (336) 527-7000

706 W King St
Kings Mtn, NC 28086
Phone (704) 730-5108

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

433 McAlister Rd
Lincolnton, NC 28092
Phone (704) 512-7000

1000 Healing Way
Matthews, NC 28104
Phone (800) 821-1535

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

201 E Grover St
Shelby, NC 28150
Phone (704) 487-3000

2301 US Highway 74 W
Wadesboro, NC 28170
Phone (704) 694-5131

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

1700 Skylyn Dr
Spartanburg, SC 29307
Phone (864) 573-3123

Interoperability endpoints

  • Direct secure messaging: cjacobs531025@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1639317308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30637",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282300637",
            "telephone_number": "704-973-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD FL 4",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-973-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "WILLIAM",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-03",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "SC",
            "license": "34271",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "2011-01022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "34271",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "2011-01022",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.