Diane J Jacobi
SSM AUDRAIN HEALTH CARE INC


Address: 1223 E Main St, Ssm Health Medical Group Family Medicine, Perry, MO 63462-1410
Phone: 5735652213

Diane J Jacobi (NPI# 1912983560, PAC ID# 0042217168) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.

Physician Overview

Nation Provider ID (NPI) 1912983560
PAC ID by PECOS 0042217168
Professional Enrollment ID I20061103000082
Full Name Diane J Jacobi
Organization Legal Name SSM AUDRAIN HEALTH CARE INC
Address 1223 E Main St
Ssm Health Medical Group Family Medicine
Perry
MO 63462-1410
Phone Number 5735652213
Gender F
Credential MD
Medical School UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduation Year 1993
Primary Specialty FAMILY MEDICINE
Group Practice PAC ID 3678481827
Number of Group Practice Members 38
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
260064 SSM HEALTH ST. MARY'S HOSPITAL-AUDRAIN
260068 BOONE HOSPITAL CENTER

Other Locations

Address Phone Organization
3626 S Clark St, Suite A, Mexico, MO 65265-4104 5735818590 SSM AUDRAIN HEALTH CARE INC
3626 S Clark St C, Mexico, MO 65265-4104 5735820850 SSM AUDRAIN HEALTH CARE INC
1223 E Main St, Ssm Health Medical Group Family Medicine, Perry, MO 63462-1410 5735652213 SSM AUDRAIN HEALTH CARE INC

Organization Information

Organization Legal Name SSM AUDRAIN HEALTH CARE INC
Physicians 30

Physicians with the same organization

Name Specialty Organization Address
Regina Hill Nurse Practitioner Ssm Audrain Health Care Inc 3626 S Clark St C, Mexico, MO 65265-4104
Nathan W Skelley Orthopedic Surgery Ssm Audrain Health Care Inc 515 E Promenade, Ssm Health Medical Group Orthopedic Surgery, Mexico, MO 65265-2966
Jeffrey T Vacek Nurse Practitioner Ssm Audrain Health Care Inc 1223 E Main St, Ssm Health Medical Group Family Medicine, Perry, MO 63462-1410
Nathan T Kenyon Physical Medicine and Rehabilitation Ssm Audrain Health Care Inc 515 E Promenade St, Ssm Health Med Group, Mexico, MO 65265-2966
Kristina M Boylan Nurse Practitioner Ssm Audrain Health Care Inc 240 Pickering St, Montgomery City, MO 63361-1941
Rebecca Kelley Family Medicine Ssm Audrain Health Care Inc 201 S Main St, Ssm Health Med Grp Fam Medicine, Auxvasse, MO 65231-1624
Eric F Kondro Internal Medicine Ssm Audrain Health Care Inc 111 W Bates St, Ssm Health Medical Group Family Medicine, Wellsville, MO 63384-1616
Michael L Quinlan Internal Medicine Ssm Audrain Health Care Inc 600 Medical Park Dr, Mexico, MO 65265-3724
Simon Mckeown Family Medicine Ssm Audrain Health Care Inc 350 Country Meadow Ln, Fulton, MO 65251-5278
Michael T Kinkade Family Medicine Ssm Audrain Health Care Inc 204 W Washington St, Vandalia, MO 63382-1473

Office Location

Street Address 1223 E MAIN ST
SSM HEALTH MEDICAL GROUP FAMILY MEDICINE
City PERRY
State MO
Zip 63462-1410

Physicians in the same location

Name Specialty Organization Address
Jeffrey T Vacek Nurse Practitioner Ssm Audrain Health Care Inc 1223 E Main St, Ssm Health Medical Group Family Medicine, Perry, MO 63462-1410

Competitor

Search similar physicians

City PERRY
Zip Code 63462
Specialty FAMILY MEDICINE
City + Specialty PERRY + FAMILY MEDICINE

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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