Tyler Yvonne Jacobs, APRN
Individual provider Active NPI Family Nurse Practitioner · Sylvester, GA
NPI 1760053144 · NPPES record last updated Jul 7, 2021
Key facts
- NPI
- 1760053144
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN268923 (GA)
- Practice address
- 304 N Westberry St
Sylvester, GA 31791-2125 - Phone
- (229) 463-7071
- Fax
- (229) 463-7081
- NPI assigned
- Jul 7, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Access Medical Clinic Georgia LLC
Practice addresses (Care Compare)
37 Hwy 341 Bypass
Hawkinsville, GA 31036
Phone (870) 856-1202
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210729002300 | GA | Practitioner - Nurse Practitioner | 3577966449 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN268923 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Medical Clinic Georgia LLC | Current |
Accepting new patients | |
| Access Medical Clinic Georgia LLC | Current |
Accepting new patients |
Locations
4196 Highway 62 412
#A
Hardy, AR 72542
Phone (870) 856-2100
3311 Lee St
Brunswick, GA 31520
Phone (912) 264-1857
2708 Lee St
Brunswick, GA 31520
Phone (912) 265-6771
37 341 Byp
Hawkinsville, GA 31036
Phone (478) 845-4842
3020 Jeffersonville Rd
Macon, GA 31217
Phone (229) 463-7081
12884 Cleveland St W
Nahunta, GA 31553
Phone (912) 462-6044
500 Stanley St
Perry, GA 31069
Phone (229) 463-7071
304 N Westberry St
Sylvester, GA 31791
Phone (229) 463-7071
200 S Kimberly Rd
Warner Robins, GA 31088
Phone (478) 293-4900
801 Elberta Rd
Warner Robins, GA 31093
Phone (478) 923-3146
Interoperability endpoints
- tyler.jacobs.1@22235.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN268923 | GA | Yes |
Addresses
Primary practice location
304 N Westberry St
Sylvester, GA 31791-2125
Mailing address
4196 Highway 62 412 Ste a
Hardy, AR 72542-8002
Phone (870) 856-1202
Other providers in Sylvester, GA
- Mary W Houston
- Albert Hugh Hudson
- Benjamin Hudson
- J. H. Harvey, Co., LLC
- Stephanie S Jackson
- William R Jenkins Jr.
- Terri Shanice Johnson
- K&L Luxury Transportation
- Mikell Karsten
- Richard Steven Keene
All providers in Sylvester, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.