Active NPI
Jacob Douglas Duncan, PA-C
- Physician Assistant
- Fort Worth, TX
National Provider Identifier
1952651754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 7510 N Beach St
Fort Worth, TX 76137-1505 - Phone
- (817) 498-1818
- Fax
- (817) 581-3761
- NPI assigned
- Sep 19, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
7510 N Beach St
Fort Worth, TX 76137-1505
Mailing address
245 S Main St
Keller, TX 76248-4990
Phone (817) 875-1797
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170808001126 | TX | Order and Referring Only - Physician Assistant | 7315190568 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498780800000",
"number": "1952651754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 S MAIN ST",
"city": "KELLER",
"state": "TX",
"postal_code": "762484990",
"telephone_number": "817-875-1797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7510 N BEACH ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761371505",
"telephone_number": "817-498-1818",
"fax_number": "817-581-3761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNCAN",
"first_name": "JACOB",
"middle_name": "DOUGLAS",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-19",
"last_updated": "2017-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; 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.