RICHARD ALBERT JACOB (NPI# 1720530934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720530934 |
| Entity Type | Individual |
| Full Name | RICHARD ALBERT JACOB |
| Credential | PA-C |
| Practice Address |
2728 Sunset Blvd Ste 400 West Columbia SC 29169-4839 |
| Mailing Address |
Po Box 6069 West Columbia SC 29171-6069 |
| Practice Telephone | 8039367095 |
| Practice Fax Number | 8039367908 |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2020-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2671 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316061179 | Richard Keith Jacob Jr. | Surgery | 2151 W Spring St Ste B210, Monroe, GA 30655 | 2007-03-19 |
| 1255476651 | Richard P. Jacob | Dentist | 821 W Meeting St, Lancaster, SC 29720-2201 | 2007-02-21 |
| 1093792640 | Richard Jacob | Internal Medicine | 26800 Crown Valley Pkwy, Suite 250, Mission Viejo, CA 92691-6384 | 2005-12-26 |
| Street Address |
2728 SUNSET BLVD STE 400 |
| City | WEST COLUMBIA |
| State | SC |
| Zip Code | 29169-4839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659347201 | Phillip Ron Ferrell | Physician Assistant | 2728 Sunset Blvd Ste 400, West Columbia, SC 29169-4839 | 2006-02-24 |
| 1760958532 | Paige E Perreault | Physician Assistant | 2728 Sunset Blvd Ste 400, West Columbia, SC 29169-4839 | 2018-10-19 |
| 1700388626 | Rebecca E Jackson | Nurse Practitioner | 2728 Sunset Blvd Ste 400, West Columbia, SC 29169-4839 | 2018-03-07 |
| 1083963144 | Stephanie Brooke Huston | Nurse Practitioner | 2728 Sunset Blvd Ste 400, West Columbia, SC 29169-4839 | 2012-09-05 |
| 1841560513 | Lexington County Health Services District, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2728 Sunset Blvd Ste 400, West Columbia, SC 29169-4839 | 2012-01-11 |
| 1962723809 | Jonathan Jay Sexton | Surgery | 2728 Sunset Blvd Ste 400, West Columbia, SC 29169-4839 | 2010-06-15 |
| 1619299708 | Brandie Yvette Bernagozzi | Physician Assistant | 2728 Sunset Blvd Ste 400, West Columbia, SC 29169-4839 | 2010-02-17 |
| 1912193087 | William Martin Yarbrough | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2728 Sunset Blvd Ste 400, West Columbia, SC 29169-4839 | 2007-09-21 |
| 1538291497 | Melody S Heffline | Nurse Practitioner | 2728 Sunset Blvd Ste 400, West Columbia, SC 29169-4839 | 2007-03-09 |
| 1073672358 | Heather Mcginnis Currier | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2728 Sunset Blvd Ste 400, West Columbia, SC 29169-4839 | 2006-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960726 | Jerry Scott Oreilly | Physical Therapy Assistant | 100 Dreher Rd, Suite 100, West Columbia, SC 29169 | 2020-07-23 |
| 1134759921 | A&m Medical, LLC | Durable Medical Equipment & Medical Supplies | 1053 Sunset Boulevard, West Columbia, SC 29169 | 2020-01-21 |
| 1750946067 | First Physical Therapy, LLC | Clinic/Center | 100 Dreher Rd., Suite 100, West Columbia, SC 29169 | 2019-05-02 |
| 1295217545 | Tynaka Kwans Wilson | Nurse Practitioner | Sc House Calls Inc, 1053 Center Street, West Columbia, SC 29169 | 2018-09-04 |
| 1588183826 | Kimberly Jane Jennings | Registered Nurse | 1052 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2017-09-19 |
| 1164943213 | Jacob Luke Wayland | Emergency Medicine | Lexington Medical Center-emergency Medicine Dept, 2720 Sunset Blvd, West Columbia, SC 29169 | 2017-06-29 |
| 1740721232 | Heather Detwiler | Physical Therapy Assistant | 2705 Leaphart Rd., Carolina Gardens, West Columbia, SC 29169 | 2017-03-16 |
| 1588110761 | Virginia I Hall | Nurse Practitioner | 2720 Susnet Blvd, West Columbia, SC 29169 | 2016-08-29 |
| 1215395744 | Stacey Khalifa | Social Worker | 160 Medical Cir Fl 1, West Columbia, SC 29169 | 2016-01-28 |
| 1407252331 | Sandy Frye Boone | Counselor | 2318 Sunset Blvd # 2a, West Columbia, SC 29169 | 2014-11-04 |
| Find all providers in zip 29169 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659347201 | Phillip Ron Ferrell | Physician Assistant | 2728 Sunset Blvd Ste 400, West Columbia, SC 29169-4839 | 2006-02-24 |
| 1538141973 | Andrew John Palmer | Physician Assistant | 222 E Medical Ln Ste 100&200, West Columbia, SC 29169-4847 | 2005-11-18 |
| 1720621113 | Joseph Ryan Sturkie | Physician Assistant | 222 E Medical Ln Ste 100&200, West Columbia, SC 29169-4847 | 2019-10-18 |
| 1760958532 | Paige E Perreault | Physician Assistant | 2728 Sunset Blvd Ste 400, West Columbia, SC 29169-4839 | 2018-10-19 |
| 1396296604 | Rebekah Leigh O'dell | Physician Assistant | 222 E Medical Ln Ste 100&200, West Columbia, SC 29169-4847 | 2016-10-21 |
| 1205296613 | Eric D Roberts | Physician Assistant | 146 E Hospital Dr Ste 400, West Columbia, SC 29169-4800 | 2016-02-26 |
| 1891168555 | Kristin K Devito | Physician Assistant | 146 E Hospital Dr Ste 400, West Columbia, SC 29169-4800 | 2015-11-03 |
| 1407224090 | Elizabeth Claire Mitchell | Physician Assistant | 146 E Hospital Dr Ste 350, West Columbia, SC 29169-4800 | 2015-09-13 |
| 1437410594 | Melissa Kay Hodges | Physician Assistant | 222 E Medical Ln Ste 101, West Columbia, SC 29169-4850 | 2012-06-06 |
| 1902127491 | Marilyn C Keen | Physician Assistant | 146 E Hospital Dr Ste 400, West Columbia, SC 29169-4800 | 2010-06-18 |
| Find all providers in WEST COLUMBIA | ||||
| City | WEST COLUMBIA |
| Zip Code | 29169 |
Please comment or provide details below to improve the information on RICHARD ALBERT 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.