SUSAN JACOB (NPI# 1508951872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508951872 |
| Entity Type | Individual |
| Full Name | SUSAN JACOB |
| Credential | MD |
| Practice Address |
55 Brendon Way Suite 100 Zionsville IN 46077-1955 |
| Practice Telephone | 3178736700 |
| Practice Fax Number | 3178738200 |
| Mailing Telephone | 3178736700 |
| Mailing Fax Number | 3178738200 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2014-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 01049258 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200270340 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821468257 | Susan Jacob | Nurse Practitioner | 212 Angela Ln, Stafford, TX 77477 | 2015-09-28 |
| 1699865881 | Susan C Jacob | Allergy & Immunology | 801 Alma St, Tomball, TX 77375 | 2006-10-16 |
| 1245246503 | Susan M. Jacob | Counselor | 1101 Dove St, Suite 160, Newport Beach, CA 92660-2839 | 2006-07-31 |
| 1356964431 | Susan Jacob | Student in an Organized Health Care Education/Training Program | 3459 5th Ave Ste 9, Pittsburgh, PA 15213-3236 | 2020-05-22 |
| 1306315130 | Susan Jacob | Nurse Practitioner | 1380 River Bend Dr, Dallas, TX 75247-4914 | 2018-11-22 |
| 1801134390 | Susan Biji Jacob | Nurse Practitioner | 4400 N Lincoln Blvd, Oklahoma City, OK 73105-5104 | 2013-01-18 |
| 1487991246 | Susan Jacob | Pharmacist | 5473 Nw Saint James Dr, Port Saint Lucie, FL 34983-3444 | 2013-01-12 |
| 1467675819 | Susan Vivian Jacob | Psychologist | 14 Vanderventer Ave, Port Washington, NY 11050-3737 | 2007-04-11 |
| 1568685436 | Susan Jacob | Nurse Practitioner | 710 W 168th Street, New York, NY 10032-2699 | 2007-04-10 |
| 1538207220 | Susan Jacob | Family Medicine | 231 Albert Sabin Way, Cincinnati, OH 45267-2827 | 2007-02-02 |
| Street Address |
55 BRENDON WAY SUITE 100 |
| City | ZIONSVILLE |
| State | IN |
| Zip Code | 46077-1955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285624429 | Barbara A. Matakevich | Obstetrics & Gynecology | 55 Brendon Way, Zionsville, IN 46077-1961 | 2005-10-27 |
| 1609201680 | Michelle Marie Duncan | Nurse Practitioner | 55 Brendon Way, Suite 100, Zionsville, IN 46077-1955 | 2013-09-09 |
| 1538343009 | Jls Family Medicine PC | Clinic/Center | 55 Brendon Way, Suite 800, Zionsville, IN 46077-1961 | 2007-12-19 |
| 1881893923 | Aristotle Healthcare, L.L.C. | Optometrist | 55 Brendon Way, Suite 900, Zionsville, IN 46077-1961 | 2007-07-17 |
| 1639376056 | Sara Naderi | Dentist | 55 Brendon Way, Suite 200, Zionsville, IN 46077-1961 | 2007-06-29 |
| 1972704716 | Zionsville Pediatric Dentistry | Dentist | 55 Brendon Way, Suite 500, Zionsville, IN 46077-1961 | 2007-05-30 |
| 1285849323 | Zionsville Family Practice | Family Medicine | 55 Brendon Way, Ste 300, Zionsville, IN 46077-1961 | 2007-05-11 |
| 1972725570 | Dr Luke LLC | Family Medicine | 55 Brendon Way, Suite 800, Zionsville, IN 46077-1961 | 2007-05-03 |
| 1093876443 | Nancy Lyon Havlik | Dermatology | 55 Brendon Way, Suite 600, Zionsville, IN 46077-1961 | 2006-12-12 |
| 1518035088 | Melissa A Mchenry | Dentist | 55 Brendon Way, Suite 500, Zionsville, IN 46077-1958 | 2006-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174029789 | Amelia S Bruner | Family Medicine | 1325 Wood Valley Ct, Zionsville, IN 46077 | 2018-04-03 |
| 1982073078 | Visionelle Eyecare Inc | Clinic/Center | 6618 Whitestown Parkway, Zionsville, IN 46077 | 2015-09-18 |
| 1487065272 | Michael J Gallagher | Family Medicine | 51 N Ford Rd, Zionsville, IN 46077 | 2014-05-14 |
| 1518377381 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 6650 Whitestown Parkway, Whitestown, IN 46077 | 2014-05-02 |
| 1962828418 | Gordon Charles Colson | Family Medicine | 6733 Jons Station, Zionsville, IN 46077 | 2014-03-07 |
| 1285977033 | Vivian Cruz Nanagas | Allergy & Immunology | 4400 Weston Pointe Dr Ste 150, Zionsville, IN 46077 | 2013-03-30 |
| 1861643926 | Mark Chandrahant Lakshmanan | Internal Medicine | 1955 Mulsanne Drive, Zionsville, IN 46077 | 2008-10-08 |
| 1275780363 | Sarah S Alexander | Occupational Therapist | 825 West Pine St, Zionsville, IN 46077 | 2008-08-20 |
| 1346405909 | Harold Hibbs | Internal Medicine | 1475 West Oak Street #138, Zionsville, IN 46077 | 2008-07-23 |
| 1548444771 | Christopher C Romas, D.d.s., P.C. | Clinic/Center | 1155 Parkway Dr., Suite 100, Zionsville, IN 46077 | 2007-12-24 |
| Find all providers in zip 46077 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417556465 | Neuro Health Indianapolis LLC | Family Medicine | 1553 W Oak St, Zionsville, IN 46077-1840 | 2020-10-21 |
| 1174029789 | Amelia S Bruner | Family Medicine | 1325 Wood Valley Ct, Zionsville, IN 46077 | 2018-04-03 |
| 1487065272 | Michael J Gallagher | Family Medicine | 51 N Ford Rd, Zionsville, IN 46077 | 2014-05-14 |
| 1962828418 | Gordon Charles Colson | Family Medicine | 6733 Jons Station, Zionsville, IN 46077 | 2014-03-07 |
| 1952643603 | Holly Nichole Smith | Family Medicine | 6866 W Stonegate Dr, Suite 100, Zionsville, IN 46077-8050 | 2013-03-20 |
| 1972771517 | Melissa Anne Laborsky | Family Medicine | 99 N First St Ste 300, Zionsville, IN 46077-1545 | 2008-02-18 |
| 1508931650 | Daniel L Shull | Family Medicine | 1650 W Oak St Ste 103, Zionsville, IN 46077-3835 | 2006-11-22 |
| 1235162074 | Michelle Mccarthy | Family Medicine | 1650 W Oak St Ste 101, Zionsville, IN 46077-3835 | 2006-07-07 |
| 1366403370 | Sacred Heart Healthcare System | Family Medicine | 5802 Chestnut St, Zionsville, PA 18092-2105 | 2006-03-29 |
| 1558320051 | Richard W Boersma | Family Medicine | 10801 N Michigan Rd Ste 110, Zionsville, IN 46077-8171 | 2006-03-22 |
| Find all providers in ZIONSVILLE | ||||
| City | ZIONSVILLE |
| Zip Code | 46077 |
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| 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.