Active NPI
Thomas A Jacobs, DPM
- Podiatrist
- Columbus, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 000578
- 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, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00373172C | Medicaid | GA |
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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000578 | GA | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Sierra Medical Clinic, Inc. | Current | Accepting new patients | |
| Western Sierra Medical Clinic, Inc. | Current | 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
- 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.
-
- Urgent Care Clinic/Center
- Downieville, CA
- NPI 1851513469
-
dba Western Sierra Medical Center
- Federally Qualified Health Center (FQHC)
- Grass Valley, CA
- NPI 1063496396
-
- Federally Qualified Health Center (FQHC)
- Oregon House, CA
- NPI 1780463257
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sierra Nevada Memorial Hospital
- General Acute Care Hospital
- Grass Valley, CA
- NPI 1659361392
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.