Active NPI
Rhema Susan Jacob, D.O.
- Psychiatry Physician
- Keller, TX
National Provider Identifier
1972980076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- R6211
- Practice address
- 1722 Keller Pkwy Ste 124
Keller, TX 76248-3749 - Phone
- (817) 527-1554
- Fax
- (949) 404-8846
- NPI assigned
- Apr 28, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | R6211 | TX | Primary |
Addresses
Primary practice location
1722 Keller Pkwy Ste 124
Keller, TX 76248-3749
Mailing address
1722 Keller Pkwy Ste 124
Keller, TX 76248-3749
Phone (817) 527-1554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715299200000",
"number": "1972980076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1722 KELLER PKWY STE 124",
"city": "KELLER",
"state": "TX",
"postal_code": "762483749",
"telephone_number": "817-527-1554",
"fax_number": "949-404-8846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1722 KELLER PKWY STE 124",
"city": "KELLER",
"state": "TX",
"postal_code": "762483749",
"telephone_number": "817-527-1554",
"fax_number": "949-404-8846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "RHEMA",
"middle_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-28",
"last_updated": "2024-05-10",
"certification_date": "2024-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "R6211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keller, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.