MICHAEL D JACOB (NPI# 1508824905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508824905 |
| Entity Type | Individual |
| Full Name | MICHAEL D JACOB |
| Credential | CRNA |
| Practice Address |
7150 Clearvista Drive Indianapolis IN 37043 |
| Mailing Address |
6626 E 75th St Indianapolis IN 46250-2805 |
| Practice Telephone | 3176215890 |
| Practice Fax Number | 3173552205 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2015-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 28181433A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | 103360 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200926510 | 05 | |
| IN | ANTHEM | 000000595410 | 01 |
| TN | 3628323 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861965816 | Michael Jacob | Counselor | 415 E Madison St, South Bend, IN 46617-2322 | 2019-01-02 |
| 1821502154 | Michael Blake Jacob | Orthopaedic Surgery | 2855 Campus Dr, Plymouth, MN 55441-2649 | 2017-11-22 |
| 1184966582 | Michael Simon Jacob | Psychiatry & Neurology | 4150 Clement St, San Francisco, CA 94121-1563 | 2013-03-23 |
| 1841374253 | Michael Jacob | Physical Therapist | 430 Kele St, Ste 401, Kahului, HI 96732-3406 | 2006-10-24 |
| Street Address |
7150 CLEARVISTA DRIVE |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 37043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265414965 | Frederick Wickwire | Nurse Anesthetist, Certified Registered | 7150 Clearvista Drive, Indianapolis, IN 46256-1695 | 2005-11-17 |
| 1255795787 | Katherine Cothern | Pediatrics | 7150 Clearvista Drive, Community Pediatric Hospitalists, Indianapolis, IN 46256-1695 | 2016-04-11 |
| 1811175300 | Shannon M Giltner | Nurse Practitioner | 7150 Clearvista Drive, Neonatal Department, Indianapolis, IN 46256-1695 | 2008-02-06 |
| 1871779157 | Community Hospitals of Indiana Inc | Obstetrics & Gynecology | 7150 Clearvista Drive, Laborist Dept, Indianapolis, IN 46256-4699 | 2008-01-16 |
| 1497931786 | Community Hospitals of Indiana Inc | Nurse Practitioner | 7150 Clearvista Drive, Neonatal Dept, Indianapolis, IN 46256-4699 | 2008-01-16 |
| 1992909105 | Community Hospitals of Indiana Inc | Hospitalist | 7150 Clearvista Drive, Chn Pediatric Unit, Indianapolis, IN 46256-1695 | 2007-06-12 |
| 1659434710 | James Andrew Eads | Nurse Anesthetist, Certified Registered | 7150 Clearvista Drive, Indianapolis, IN 46256 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952958464 | Barbara Gallahan | Technician | 3992 Lakewood Dr., Clarksville, TN 37043 | 2019-08-20 |
| 1144874728 | Intricate Care | Registered Nurse | 2299 Raleigh Ct, Clarksville, TN 37043 | 2019-07-31 |
| 1740842145 | Caila Anne Wiblitzhouser Holm | Counselor | 755 Weatherly Drive, Clarksville, TN 37043 | 2019-07-05 |
| 1407416407 | Heartland Dental Care of Tennessee, PC | Dentist | 930 Highway 76, Clarksville, TN 37043 | 2019-06-20 |
| 1376021501 | Stephen Lawrence Rego | Case Manager/Care Coordinator | Cohen Military Family Clinic, 775 Weatherly Dr, Clarksville, TN 37043 | 2018-07-31 |
| 1366928095 | Kendra Lee | Social Worker | 775 Weatherly Dr., Clarksville, TN 37043 | 2018-07-16 |
| 1245742931 | Andrea L Edelstein | Dentist | 1818 Memorial Dr., Unit 47, Clarksville, TN 37043 | 2017-11-02 |
| 1043736119 | Megan Pritchett Landre | Behavior Technician | 990 South Ridge Trail, Clarksville, TN 37043 | 2017-08-20 |
| 1932624798 | Sandra Melissa Corral | Behavior Technician | 139e Old Trenton Rd, Suite B, Clarksville, TN 37043 | 2017-08-13 |
| 1700306032 | Sahiti Kandati | Dentist | 1777 Madison Ste Ste 100, Clarksville, TN 37043 | 2017-06-27 |
| Find all providers in zip 37043 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598139784 | Gloria Clampitt | Nurse Anesthetist, Certified Registered | 4719 Moss Creek Ct, Indianapolis, IN 46237-2940 | 2015-11-25 |
| 1891832754 | Daniel Hayden | Nurse Anesthetist, Certified Registered | 7150 Clearvista Avenue, Indianapolis, IN 46256 | 2007-01-31 |
| 1174506042 | Nancy Louise Alltop II | Nurse Anesthetist, Certified Registered | 1500 N. Ritter Avenue, Indianapolis, IN 46227-0963 | 2005-11-23 |
| 1265414965 | Frederick Wickwire | Nurse Anesthetist, Certified Registered | 7150 Clearvista Drive, Indianapolis, IN 46256-1695 | 2005-11-17 |
| 1659379873 | Raymond Edward Baker | Nurse Anesthetist, Certified Registered | 1500 N Ritter Ave, Indianapolis, IN 46219-3027 | 2005-07-12 |
| 1801403928 | Morgan Lewis | Nurse Anesthetist, Certified Registered | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2020-09-24 |
| 1336764158 | Kristina A Vasnaik | Nurse Anesthetist, Certified Registered | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2020-06-09 |
| 1528550241 | Midwest Gastroenterology LLC | Nurse Anesthetist, Certified Registered | 8051 S Emerson Ave Ste 150, Indianapolis, IN 46237 | 2018-05-30 |
| 1295104883 | Jane B Parker Crna LLC | Nurse Anesthetist, Certified Registered | 9002 N Meridian St, Indianapolis, IN 46260-5381 | 2015-09-24 |
| 1760871362 | Jessica Crosby | Nurse Anesthetist, Certified Registered | 7150 Clearvista Dr, Indianapolis, IN 46256 | 2015-01-20 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 37043 |
Please comment or provide details below to improve the information on MICHAEL D JACOB.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.