Active NPI
Addison F Jacobs, MD
- Diagnostic Radiology Physician
- Scott Air Force Base, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 33917
- Practice address
- 310 W Losey St
Scott Air Force Base, IL 62225-5250 - Phone
- (618) 256-9355
- NPI assigned
- Mar 13, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 2026006949 | MO | |
| Diagnostic Radiology Physician | 2085R0202X | 036178029 | IL | |
| General Practice Physician | 208D00000X | 33917 | NE | |
| Diagnostic Radiology Physician | 2085R0202X | 33917 | NE | Primary |
Addresses
Primary practice location
310 W Losey St
Scott Air Force Base, IL 62225-5250
Mailing address
310 W Losey St
Scott Air Force Base, IL 62225-5250
Phone (618) 256-9355
Other practice location 1
927 Broadway St
Quincy, IL 62301-2719
Phone (217) 223-8400
Other practice location 2
100 Medical Dr
Hannibal, MO 63401-6877
Phone (217) 223-8400
Other practice location 3
4800 Maine St
Quincy, IL 62305-5875
Phone (217) 223-8400
Other practice location 4
Walter Reed Military Medical Center
8901 Wisconsin Avenue
Bethesda, MD 20889
Phone (301) 295-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, MO, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Georgetown University School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Saint Louis, MO 63108
Phone (309) 671-8282
Hannibal, MO 63401
Phone (309) 671-8282
100 Medical Dr
Hannibal, MO 63401-6877
Phone (217) 223-8400
4938 Pershing PL
Saint Louis, MO 63108-1202
Phone (615) 312-0600
7034 Lindell Blvd
Saint Louis, MO 63130-4401
Phone (708) 915-5671
8820 S Laclede Station Rd
Saint Louis, MO 63123-3029
Phone (708) 915-5671
927 Broadway St
Quincy, IL 62301-2719
Phone (217) 224-6423
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036178029 | IL | MD | Diagnostic Radiology Physician |
| 2026006949 | MO | MD | Diagnostic Radiology Physician |
| 33917 | NE | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Specialists in Medical Imaging, SC | Diagnostic Radiology | Current | Accepting new patients |
| Central Illinois Radiological Associates, LTD. | Diagnostic Radiology | Current | Accepting new patients |
| Imaging Associates of Indiana, PC | Diagnostic Radiology | Current | Accepting new patients |
| Cira Michigan PC | Diagnostic Radiology | Past | Accepting new patients |
Locations
5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
530neglen Oak Ave
Peoria, IL 61636
Phone (309) 685-1054
111 Spring St
Streator, IL 61364
Phone (815) 672-4587
1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000
1015 W Adams St
Bowling Green, MO 63334
Phone (573) 324-5300
100 Medical Dr
Hannibal, MO 63401
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.
-
- Diagnostic Radiology Physician
- Olympia Fields, IL
- NPI 1841687951
MO
-
- Diagnostic Radiology Physician
- Owensboro, KY
- NPI 1639115447
MO
-
- Diagnostic Radiology Physician
- Peoria, IL
- NPI 1538192828
-
- Obstetrics & Gynecology Physician
- Flint, MI
- NPI 1982630844
-
- Diagnostic Radiology Physician
- Nashville, TN
- NPI 1861478489
-
- Diagnostic Radiology Physician
- Escanaba, MI
- NPI 1972141513
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Quincy, IL
- NPI 1760571699
-
- General Acute Care Hospital
- Owensboro, KY
- NPI 1285613612
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773792000000",
"number": "1679109482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 W LOSEY ST",
"city": "SCOTT AIR FORCE BASE",
"state": "IL",
"postal_code": "622255250",
"telephone_number": "618-256-9355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 W LOSEY ST",
"city": "SCOTT AIR FORCE BASE",
"state": "IL",
"postal_code": "622255250",
"telephone_number": "618-256-9355"
}
],
"practiceLocations": [
{
"address_1": "927 Broadway St",
"address_purpose": "LOCATION",
"city": "Quincy",
"state": "IL",
"postal_code": "623012719",
"country_code": "US",
"telephone_number": "217-223-8400",
"fax_number": "217-277-3960",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 Medical Dr",
"address_purpose": "LOCATION",
"city": "Hannibal",
"state": "MO",
"postal_code": "634016877",
"country_code": "US",
"telephone_number": "217-223-8400",
"fax_number": "217-277-3960",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4800 Maine St",
"address_purpose": "LOCATION",
"city": "Quincy",
"state": "IL",
"postal_code": "623055875",
"country_code": "US",
"telephone_number": "217-223-8400",
"fax_number": "217-277-3960",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "Walter Reed Military Medical Center",
"address_2": "8901 Wisconsin Avenue",
"address_purpose": "LOCATION",
"city": "Bethesda",
"state": "MD",
"postal_code": "20889",
"country_code": "US",
"telephone_number": "301-295-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBS",
"first_name": "ADDISON",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-13",
"last_updated": "2026-03-18",
"certification_date": "2026-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "2026006949",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036178029",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NE",
"license": "33917",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NE",
"license": "33917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scott Air Force Base, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.