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JACOBS CLINIC, INC.
NPI 1033508791
Nurse Practitioner - Family in Waycross, GA

Active since January 20, 2015CLIA 11D2092853 · Waiver
403 LISTER ST, A, WAYCROSS, GA 31501(912) 816-8956 Get Directions Write a Review

NPPES record last updated: January 20, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1033508791
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameJACOBS CLINIC, INC.
Location Address403 LISTER ST, AWaycross, GA 31501-5225
Mailing Address403 Lister St, AWaycross, GA 31501-5225 · (912) 816-8956
Phone(912) 816-8956
Organization SubpartNo
Authorized OfficialRobert Scott JacobsNurse Practitioner/owner · (912) 816-8956
Enumeration DateJanuary 20, 2015
✔ NPI 1033508791 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · RN121991NP
403 LISTER ST, Waycross, GA 31501
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Other Identifiers 1

Medicare UPINP35295GA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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, GA
Active · expires Mar 15, 2027
CLIA Number11D2092853
Laboratory TypePractitioner Other
Certificate Effective DateMarch 16, 2025
Certificate Expiration DateMarch 15, 2027
Laboratory DirectorRobert S. Jacobs
Laboratory Phone(000) 912-2834
Laboratory LocationJacobs Clinic, Inc403A Lister Street, Waycross, GA 31501
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES S. BLASKO, M.D. P.C.
Family Medicine
403 LISTER ST
WAYCROSS, GA 31501
Ware County (912) 283-4422

Frequently 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.

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.

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.