Nadia Diana Jacob

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

113536 Issued in GA

Practice address

1147 NW 64TH Ter
Gainesville, FL 32605-4218

Phone

(352) 333-5982

NPI assigned

Mar 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: nadia.jacob@hca5.eclinicaldirectplus.com

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1902556129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 NW 64TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054218",
            "telephone_number": "352-333-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 NW 64TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054218",
            "telephone_number": "352-333-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "NADIA",
        "middle_name": "DIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "113536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shalyon Jackson
• Shantavia Jackson
• Tina Shanette Jackson
• Kevin Jacob, DO
• Lukose Jacob, LCSW
• R Patrick Jacob, MD
• Benjamin Norman Jacobs, M.D.
• Brian P Jacobs
• Ciara Jacobs
• Dean Jacobs, PHARMD

• Psychiatry Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.