JACOBS CLINIC, INC.
NPI 1033508791
Nurse Practitioner - Family in Waycross, GA
About Jacobs Clinic, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACOBS CLINIC, INC. (NPI 1033508791) is a healthcare organization registered as a family in Waycross, Georgia and active in the NPI registry since January 2015. The organization holds a CLIA Waiver certificate valid through March 15, 2027 and lists Robert Scott Jacobs, Nurse Practitioner/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jacobs Clinic, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Jacobs Clinic, Inc., which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 11D2092853
Jacobs Clinic, Inc · Waycross, GAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jacobs Clinic, Inc.'s NPI number?
The NPI number for Jacobs Clinic, Inc. is 1033508791. It was assigned to this organization in the NPPES registry on January 20, 2015.
Where is Jacobs Clinic, Inc. located?
Jacobs Clinic, Inc. is located at 403 Lister St A, Waycross, GA 31501. The listed phone number is (912) 816-8956.
What is Jacobs Clinic, Inc.'s specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jacobs Clinic, Inc. enrolled in Medicare?
Yes. Jacobs Clinic, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jacobs Clinic, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Jacobs Clinic, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Jacobs Clinic, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D2092853) is associated with this NPI, valid through March 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Jacobs Clinic, Inc. accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Jacobs Clinic, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jacobs Clinic, Inc. was last updated on January 20, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jacobs Clinic, Inc. · NPI 1033508791
Family organization in Waycross, Georgia. Organization record, active in the CMS NPPES registry since January 20, 2015.
## Identity
- **NPI:** 1033508791 (Entity type: Organization)
- **Enumerated:** January 20, 2015
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Robert Jacobs, NURSE PRACTITIONER/OWNER
## Practice location
- **Address:** 403 LISTER ST, A, Waycross, GA 31501-5225
- **Phone:** (912) 816-8956
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 20, 2015
- **Other identifiers:** Medicare UPIN P35295 (GA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1033508791) · Data from the CMS NPPES public registry.