Phillip Brian Jacobs, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

720 Issued in SC

Practice address

136 Church Street
Chester, SC 29706

Phone

(803) 581-7400

Fax

(803) 581-0124

NPI assigned

Apr 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University College of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Eye Care Services Inc

  • Optometrist
  • Chester, SC
  • NPI 1881885036
  Medicare reassignment NPD

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1710942784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 CHURCH STREET",
            "address_2": "PO BOX 791",
            "city": "CHESTER",
            "state": "SC",
            "postal_code": "29706",
            "telephone_number": "803-581-7400",
            "fax_number": "803-581-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 CHURCH STREET",
            "city": "CHESTER",
            "state": "SC",
            "postal_code": "29706",
            "telephone_number": "803-581-7400",
            "fax_number": "803-581-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "PHILLIP",
        "middle_name": "BRIAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD0720",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hope Community Support LLC
• Nakia Renee Houston
• Terencio L Hughes
• Takenya Tecadrian Hunter, MA, QMHP
• J D Rucker Jr DDS PA
• John D. Sherer, DMD, PA
• Franklin Benjamin Johnson, MHS PT OCS COMT
• Johnston Dental Associates, PA
• Jump Start Bridging Gaps LLC
• Lilyann Mae Kanipe

• Optometrist in Chester, SC
• Providers in Chester, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.

Verify at the official NPI Registry.