Gweneth Ferdinand-Jacob, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA969 Issued in TN

Practice address

763 McClain Dr
Clarksville, TN 37040

Phone

(931) 906-1823

Fax

(731) 352-7644

NPI assigned

Feb 24, 2006

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334620800000",
    "number": "1922074459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 MCCLAIN DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405695",
            "telephone_number": "931-906-1823",
            "fax_number": "731-352-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 MCCLAIN DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37040",
            "telephone_number": "931-906-1823",
            "fax_number": "731-352-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERDINAND-JACOB",
        "first_name": "GWENETH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2012-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "PA969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genevieve Mae Febbraro, DO
• Caleb Daniel Federspiel, FP-C
• Tammy Felix
• Megan Feller
• Lisa D Feltner, DPT
• Steffani Ferguson
• Susan Fernandez, CCC-SLP
• Dana Ferraioli
• Rachel Ferrari Wimble, BCBA
• Joanna Ferrell, APRN, FNP-C

• Medical Physician Assistant in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.