Individual provider Active NPI

Thomas A Jacobs, DPM

  • Podiatrist
  • Columbus, GA
National Provider Identifier
1730114067
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000578 Issued in GA
Practice address
1900 Tenth Avenue
Ste 120
Columbus, GA 31901
Phone
(706) 323-6914
Fax
(706) 596-1281
NPI assigned
Jul 12, 2006
Last updated
Aug 14, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 000578 GA Primary

Addresses

Primary practice location

1900 Tenth Avenue
Ste 120
Columbus, GA 31901

Mailing address

1900 Tenth Avenue
Ste 120
Columbus, GA 31901
Phone (706) 323-6914

Other identifiers 1

IdentifierTypeStateIssuer
00373172CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20201103003123 CA Practitioner - Podiatry 4981618865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

844 Old Tunnel Rd
Grass Valley, CA 95945-8524
Phone (530) 274-9762

PO Box
Suite 286
Downieville, CA 95936-0286

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000578GAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Sierra Medical Clinic, Inc. CurrentSince Jul 24, 2020 Accepting new patients
Western Sierra Medical Clinic, Inc. CurrentSince Jul 24, 2020 Accepting new patients
Western Sierra Medical Clinic, Inc. Current Accepting new patients

Locations

1345 Whispering Pines Ln
Grass Valley, CA 95945
Phone (530) 265-7895

844 Old Tunnel Rd
Grass Valley, CA 95945
Phone (530) 273-4984

Interoperability endpoints

  • Direct secure messaging: thomas.jacobs@wsmc1.eclinicaldirectplus.com

Organizations & group practices 3

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218672000000",
    "number": "1730114067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 TENTH AVENUE",
            "address_2": "STE 120",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31901",
            "telephone_number": "706-323-6914",
            "fax_number": "706-596-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 TENTH AVENUE",
            "address_2": "STE 120",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31901",
            "telephone_number": "706-323-6914",
            "fax_number": "706-596-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "THOMAS",
        "middle_name": "A",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "000578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00373172C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.