Jacob Tyler Robison, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61017451 Issued in WA

Practice address

502 Jackson St
Suite 5
Aberdeen, MS 39730-3300

Phone

(662) 369-9500

NPI assigned

Sep 1, 2015

Last updated

Jun 20, 2024By 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 WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth Southwest Home Health Home health agency, Vancouver, WA, CCN 507064
• Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

Merit-based Incentive Payment System (MIPS)

Final score

93.56 of 100Reported as group

Quality

95.87

Promoting interoperability

100

Improvement activities

40

Cost

75.98

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrobison660506@direct.peacehealth.org

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.

• Peacehealth

  dba PeaceHealth Medical Group

  • Surgery Physician
  • Vancouver, WA
  • NPI 1609061969
  Medicare reassignment Care Compare group NPD
• Peacehealth Networks on Demand, LLC

  dba Zoom Management

  • General Practice Physician
  • Tigard, OR
  • NPI 1023582178

  WA

  Medicare reassignment NPD
• Pancare of Florida, Inc

  • Federally Qualified Health Center (FQHC)
  • Bonifay, FL
  • NPI 1578376406
  NPD
• Pancare of Florida, Inc

  • Federally Qualified Health Center (FQHC)
  • Bristol, FL
  • NPI 1275346108
  NPD (past)

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

• Peacehealth

  dba PeaceHealth SW Heart & Vascular Center

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911

  Hospital

  Care Compare affiliation
• Peacehealth

  dba PeaceHealth Southwest Medical Center

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Care Compare affiliation
• Peacehealth

  dba Peacehealth Southwest Home Health

  • Home Health Agency
  • Vancouver, WA
  • NPI 1285720896
  Care Compare affiliation

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1952778359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E 11TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013409",
            "telephone_number": "850-747-5599",
            "fax_number": "850-872-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 JACKSON ST",
            "address_2": "SUITE 5",
            "city": "ABERDEEN",
            "state": "MS",
            "postal_code": "397303300",
            "telephone_number": "662-369-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16811 SE McGillivray Blvd",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986833404",
            "country_code": "US",
            "telephone_number": "360-696-5223",
            "fax_number": "360-696-5228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBISON",
        "first_name": "JACOB",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-01",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R888153",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61017451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reliant Home Care PLLC
• Reliant Home Medical Supplies and Equipment LLC
• Renal Care Group Tupelo, LLC (RCG Aberdeen)
• Vernon Robertson
• Luezarah Robinson
• Roger a. Wright, D. M. D., Dental Clinic, Inc.
• Mihika Shah
• Allison R Sledge, CCC-SLP
• John N Snider I
• The We Care Committee

• Family Nurse Practitioner in Aberdeen, MS
• Providers in Aberdeen, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.

Verify at the official NPI Registry.