Individual provider Active NPI

Danelle Andee Jacobus, PAC

  • Physician Assistant
  • Franklin, TN
National Provider Identifier
1730172503
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA809 Issued in TN
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

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3668885MedicaidTN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110211000850 TN Practitioner - Physician Assistant 4486834132 Reassigns benefits to 1 organization

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
Advanced Diagnostic Imaging PCGroup PAC ID 7315848140, 523 clinicians

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

LicenseStateTypeSpecialty
809TNMDMarriage & Family Therapist
PA809TNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endoscopy Center of St Thomas LLC Current Accepting new patients
Advanced Diagnostic Imaging, PC Gastroenterology CurrentSince May 15, 2022 Accepting new patients
Nashville Gastroenterology and Hepatology Current Accepting new patients
Advanced Diagnostic Imaging PC CurrentSince May 15, 2022 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.