Tracy Jacobs, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP10043 Issued in LA

Practice address

919 S. 10TH St.
Leesville, LA 71446

Phone

(337) 404-4106

Fax

(337) 404-4108

NPI assigned

Jul 2, 2018

Last updated

Jul 30, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advantage Health Urgent Care LLCGroup PAC ID 6608246053, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beauregard Memorial Hospital Hospital, Deridder, LA, CCN 190050

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advantage Health Urgent Care LLC

  • Acute Care Nurse Practitioner
  • Deridder, LA
  • NPI 1194435107
  Medicare reassignment Care Compare group NPD
• Advantage Health Primary Care LLC

  • Family Nurse Practitioner
  • Deridder, LA
  • NPI 1427876911
  Medicare reassignment NPD
• Calcasieu Urgent Care LLC

  dba Calcasieu Urgent Care

  • Urgent Care Clinic/Center
  • Lake Charles, LA
  • NPI 1467715490
  Medicare reassignment NPD
• Professional Pediatrics, LLC

  dba The Pediatric Center

  • Rural Health Clinic/Center
  • Leesville, LA
  • NPI 1376717959
  Medicare reassignment NPD
• Calcasieu Urgent Care, LLC

  • Rural Health Clinic/Center
  • Breaux Bridge, LA
  • NPI 1194482398
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospital Service District No 2 of Parish of Beauregard State of la

  dba Beauregard Memorial Hospital

  • Rural Acute Care Hospital
  • Deridder, LA
  • NPI 1831193499
  Care Compare affiliation

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1750877825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "NEW LLANO",
            "state": "LA",
            "postal_code": "714610130",
            "telephone_number": "337-239-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 S. 10TH ST.",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "71446",
            "telephone_number": "337-404-4106",
            "fax_number": "337-404-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "TRACY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP10043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iberia Comprehensive Community Health Center, Inc. (Vernon Parish Community Health Center)
• Ideal Care Family Medical Clinic, LLC
• Kaylin Jackson, BS, BCABA
• McKenzie Beth Jackson, RSW
• Whitney Jackson
• Crista Jeane
• Joe Hundley Rankin MD a Prof Medical Corp
• John Robert Johnson, D.C.
• Kimberly Johnson
• Lynn Johnson, RPH

• Nurse Practitioner in Leesville, LA
• Providers in Leesville, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.