Active NPI
Jacob D McClintic
- Hospitalist Physician
- La Crosse, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 01081731A
- Practice address
- 1836 South Ave
La Crosse, WI 54601-5429 - Phone
- (608) 782-7300
- NPI assigned
- Mar 29, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Hospitalist Physician | 208M00000X | 01081731A | IN | Primary |
| Internal Medicine Physician | 207R00000X | 68232 | WI |
Addresses
Primary practice location
1836 South Ave
La Crosse, WI 54601-5429
Mailing address
2600 Ferry St
Lafayette, IN 47904-3055
Phone (608) 782-7300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
5165 McCarty LN
Lafayette, IN 47905-8764
Phone (765) 448-8000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68232 | WI | MD | Internal Medicine Physician |
| 01081731A | IN | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iu Health Medical Group, LLC | Current | Accepting new patients | |
| Arnett Clinic, LLC | Current | Accepting new patients | |
| Arnett Clinic, LLC | Internal Medicine | Current | Accepting new patients |
| Arnett Clinic, LLC | Current | Accepting new patients |
Locations
8016 Reliable Pkwy
Chicago, IL 60686
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
2600 Ferry St
Lafayette, IN 47904
5165 McCarty Ln
Rm 28A
Lafayette, IN 47905
2600 Greenbush St
Lafayette, IN 47904
1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009
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
- Lafayette, IN
- NPI 1164490843
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
-
- Durable Medical Equipment & Medical Supplies
- Lafayette, IN
- NPI 1699839563
-
- Clinical Medical Laboratory
- Lafayette, IN
- NPI 1881655090
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba IU Health Arnett Hospital
- General Acute Care Hospital
- Lafayette, IN
- NPI 1326296211
-
- Critical Access Hospital
- Frankfort, IN
- NPI 1346774270
-
dba Indiana University Health
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1144266024
-
- Critical Access Hospital
- Monticello, IN
- NPI 1710983945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559260800000",
"number": "1811359847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 FERRY ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479043055",
"telephone_number": "608-782-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1836 SOUTH AVE",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546015429",
"telephone_number": "608-782-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLINTIC",
"first_name": "JACOB",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-29",
"last_updated": "2019-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IN",
"license": "01081731A",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "68232",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.