Active NPI
Danelle Andee Jacobus, PAC
- Physician Assistant
- Franklin, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA809
- Practice address
- 100 Covey Dr Ste 105
Franklin, TN 37067-5603 - Phone
- (615) 794-2747
- Fax
- (615) 591-0460
- NPI assigned
- Aug 26, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | PA809 | TN | |
| Physician Assistant | 363A00000X | 809 | TN | |
| Physician Assistant | 363A00000X | PA809 | TN | Primary |
Addresses
Primary practice location
100 Covey Dr Ste 105
Franklin, TN 37067-5603
Mailing address
3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 239-2018
Other practice location 1
4230 Harding Rd
Ste 309 West
Nashville, TN 37205-2013
Phone (615) 383-0165
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3668885 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Covey Dr
Franklin, TN 37067-5603
3443 Dickerson Pike
Suite 400
Nashville, TN 37207-2524
Phone (615) 612-2146
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 809 | TN | MD | Marriage & Family Therapist |
| PA809 | TN | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endoscopy Center of St Thomas LLC | Current | Accepting new patients | |
| Advanced Diagnostic Imaging, PC | Gastroenterology | Current | Accepting new patients |
| Nashville Gastroenterology and Hepatology | Current | Accepting new patients | |
| Advanced Diagnostic Imaging PC | Current | Accepting new patients |
Locations
100 Covey Dr
Ste 105
Franklin, TN 37067
Phone (615) 794-2747
201 Bluebird Dr
Goodlettsvlle, TN 37072
Phone (615) 338-5702
3024 Business Park Cir
Goodlettsvlle, TN 37072
Phone (615) 239-2018
2010 Church St
Ste 420
Nashville, TN 37203
Phone (615) 329-2141
3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146
2010 Church St
Ste 312
Nashville, TN 37203
Phone (615) 329-2141
Interoperability endpoints
- danelle.jacobus@ahp.eclinicaldirectplus.com
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Goodlettsville, TN
- NPI 1093741464
Gastroenterology
-
- Durable Medical Equipment & Medical Supplies
- Lewisburg, TN
- NPI 1922846559
-
- Ambulatory Surgical Clinic/Center
- Nashville, TN
- NPI 1326176215
-
- Endoscopy Clinic/Center
- Nashville, TN
- NPI 1790811222
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1730172503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3024 BUSINESS PARK CIR",
"city": "GOODLETTSVILLE",
"state": "TN",
"postal_code": "370723132",
"telephone_number": "615-239-2018",
"fax_number": "615-851-2018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 COVEY DR STE 105",
"city": "FRANKLIN",
"state": "TN",
"postal_code": "370675603",
"telephone_number": "615-794-2747",
"fax_number": "615-591-0460"
}
],
"practiceLocations": [
{
"address_1": "4230 Harding Rd",
"address_2": "Ste 309 West",
"address_purpose": "LOCATION",
"city": "Nashville",
"state": "TN",
"postal_code": "372052013",
"country_code": "US",
"telephone_number": "615-383-0165",
"fax_number": "615-292-4657",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBUS",
"first_name": "DANELLE",
"middle_name": "ANDEE",
"name_prefix": "Ms.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-26",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "TN",
"license": "PA809",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "809",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "PA809",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3668885",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Franklin, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.