Jacob Metcalf, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

143394 Issued in AL

Practice address

400 Burt Dr Apt C37
Dothan, AL 36305-1121

Phone

(334) 596-2129

NPI assigned

Jun 28, 2021

Last updated

May 22, 2023By the provider in NPPES

Sex

Male

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

Enrolled in AL, FL2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunshine State Anesthesia Partners LLCGroup PAC ID 8123434792, 429 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Fawcett Hospital Hospital, Port Charlotte, FL, CCN 100236

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sunshine State Anesthesia Partners LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1437757127
  Medicare reassignment Care Compare group NPD
• Houston County Healthcare Authority

  dba Samc-Enterprise Medical Clinic

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment NPD
• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center Medical Clinics

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fawcett Memorial Hospital, Inc.

  dba HCA Florida Fawcett Hospital

  • General Acute Care Hospital
  • Port Charlotte, FL
  • NPI 1417901406
  Care Compare affiliation

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1932779519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BURT DR APT C37",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051121",
            "telephone_number": "334-596-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BURT DR APT C37",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051121",
            "telephone_number": "334-596-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METCALF",
        "first_name": "JACOB",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "143394",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard W Merritt, DC
• Rodney W Merritt, DC
• Alexis Messina
• Metamorphosis Services, LLC
• Abygail Rose Metcalf
• Methodist Home for the Aging (Wesley Place on Honeysuckle)
• Metro Oral & Maxillofacial
• Audrey Metcalf Meuleman
• Michael Griffin PC (Dothan Optometric Clinic)
• Mid-South Home Care Services, LLC (Mid-South Respiratory Services & HME)

• Certified Registered Nurse Anesthetist in Dothan, AL
• Providers in Dothan, AL by specialty
• Certified Registered Nurse Anesthetist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.