Individual provider Active NPI

Jacob Michael Feagans, MD

  • Gastroenterology Physician
  • Santa Rosa Beach, FL
National Provider Identifier
1932389681
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME153671 Issued in FL
Practice address
23 Mack Bayou Loop
Santa Rosa Beach, FL 32459-2606
Phone
(850) 390-4540
Fax
(850) 390-4540
NPI assigned
Nov 10, 2007
Last updated
Jul 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.201317 LA
Gastroenterology Physician 207RG0100X TRN13023 FL
Gastroenterology Physician 207RG0100X 21382 MS
Gastroenterology Physician 207RG0100X ME153671 FL Primary

Addresses

Primary practice location

23 Mack Bayou Loop
Santa Rosa Beach, FL 32459-2606

Mailing address

4800 Belfort Rd
Jacksonville, FL 32256-6004
Phone (850) 390-4540

Other identifiers 2

IdentifierTypeStateIssuer
15513591OtherCAQH
113815400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220329000785 FL Practitioner - Gastroenterology 7012186489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Mercer University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Borland Groover Clinic, PAGroup PAC ID 6507761301, 128 clinicians

Practice addresses (Care Compare)

23 Mack Bayou Loop
Santa Rosa Beach, FL 32459-2606
Phone (850) 390-4540

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.94 of 100Reported as group
Quality
69.69
Promoting interoperability
89
Improvement activities
40
Cost
69.28

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy380
Upper gastrointestinal (GI) endoscopy for acid reflux497

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.201317LAMDInternal Medicine Physician
TRN13023FLMDGastroenterology Physician
21382MSMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Borland Groover Clinic, PA Gastroenterology CurrentSince May 14, 2022 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

4800 Belfort Rd
Jacksonville, FL 32256
Phone (904) 307-2084

836 Prudential Dr
Ste 801
Jacksonville, FL 32207
Phone (904) 288-0433

23 Mack Bayou Loop
Santa Rosa Beach, FL 32459
Phone (850) 390-4540

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jacob.feagans.p1@direct.bgclinic.nextgenshare.com

Organizations & group practices 2

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 4

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": "1194652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1932389681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566004",
            "telephone_number": "850-390-4540",
            "fax_number": "850-390-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MACK BAYOU LOOP",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324592606",
            "telephone_number": "850-390-4540",
            "fax_number": "850-390-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEAGANS",
        "first_name": "JACOB",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-10",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.201317",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "TRN13023",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MS",
            "license": "21382",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME153671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15513591",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113815400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa Beach, FL

Sources for this page

Verify at the official NPI Registry.