Active NPI
Jacob Michael Feagans, MD
- Gastroenterology Physician
- Santa Rosa Beach, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- ME153671
- 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, 2022
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15513591 | Other | CAQH | |
| 113815400 | Medicaid | FL |
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
Enrollment records 1
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
Practice addresses (Care Compare)
23 Mack Bayou Loop
Santa Rosa Beach, FL 32459-2606
Phone (850) 390-4540
Hospital & facility affiliations
- Sacred Heart Hospital on the Emerald Coast
- Ascension Sacred Heart Bay
- HCA Florida Twin Cities Hospital
- Sacred Heart Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.94 of 100
- Quality
- 69.69
- Promoting interoperability
- 89
- Improvement activities
- 40
- Cost
- 69.28
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 380 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 497 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD.201317 | LA | MD | Internal Medicine Physician |
| TRN13023 | FL | MD | Gastroenterology Physician |
| 21382 | MS | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Borland Groover Clinic, PA | Gastroenterology | Current | 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
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- 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.
-
- Gastroenterology Physician
- Jacksonville, FL
- NPI 1881644912
-
dba Memorial Hospital and Manor
- Multi-Specialty Clinic/Center
- Bainbridge, GA
- NPI 1053388256
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Miramar Beach, FL
- NPI 1558391771
-
dba Ascension Sacred Heart Bay
- General Acute Care Hospital
- Panama City, FL
- NPI 1720078041
-
dba HCA Florida Twin Cities Hospital
- General Acute Care Hospital
- Niceville, FL
- NPI 1891732988
-
dba Ascension Sacred Heart Pensacola
- General Acute Care Hospital
- Pensacola, FL
- NPI 1922032424
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.