Individual provider Active NPI

Anu Rebecca Jacob, MD

  • Internal Medicine Physician
  • Monroe, NC
National Provider Identifier
1801021308
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2016-01462 Issued in NC
Practice address
1550 Faulk St
Ste 3120
Monroe, NC 28112-5086
Phone
(980) 993-6320
NPI assigned
May 28, 2009
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2016-01462 NC
Internal Medicine Physician 207R00000X 2016-01462 NC Primary
Pulmonary Disease Physician 207RP1001X 2016-01462 NC

Addresses

Primary practice location

1550 Faulk St
Ste 3120
Monroe, NC 28112-5086

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

2700 S Providence Rd
Ste 180
Waxhaw, NC 28173-6313
Phone (980) 993-6320

Other practice location 2

1100 Healing Way
Ste 21A
Matthews, NC 28104-5159
Phone (980) 993-6320

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ajacob136529@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160819001568 NC Practitioner - Pulmonary Disease 5496040123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

1550 Faulk St
Suite 3120
Monroe, NC 28112-5087
Phone (980) 993-6320

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2016-01462NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Aug 1, 2016 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Critical Care Medicine CurrentSince Aug 1, 2016 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

1100 Healing Way
Ste 21A
Matthews, NC 28104
Phone (980) 993-6320

1550 Faulk St
Ste 3120
Monroe, NC 28112
Phone (980) 993-6320

2700 S Providence Rd
Ste 180
Waxhaw, NC 28173
Phone (980) 993-6320

Interoperability endpoints

  • Direct secure messaging: ajacob136529@carolinashealthcaresystem.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1801021308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 FAULK ST",
            "address_2": "STE 3120",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281125086",
            "telephone_number": "980-993-6320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 S Providence Rd",
            "address_2": "Ste 180",
            "address_purpose": "LOCATION",
            "city": "Waxhaw",
            "state": "NC",
            "postal_code": "281736313",
            "country_code": "US",
            "telephone_number": "980-993-6320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Healing Way",
            "address_2": "Ste 21A",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281045159",
            "country_code": "US",
            "telephone_number": "980-993-6320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "ANU",
        "middle_name": "REBECCA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-28",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "2016-01462",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2016-01462",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "2016-01462",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajacob136529@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1550 Faulk St",
            "address_2": "Ste 3120",
            "city": "Monroe",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281125086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

Verify at the official NPI Registry.