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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

JACOB WORDEN
NPI 1063209864
Student in an Organized Health Care Education/Training Program in Atlanta, GA

Active since April 23, 2025PECOS Enrolled
21 ORTHO LANE, SOM SUITE/5TH FLOOR, ATLANTA, GA 30329(404) 778-2516 Get Directions Write a Review

NPPES record last updated: July 17, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacob Worden NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB WORDEN (NPI 1063209864) is an individual student in an organized health care education/training program in Atlanta, Georgia and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063209864
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACOB WORDEN
Location Address21 ORTHO LANE, SOM SUITE/5TH FLOORAtlanta, GA 30329
Mailing Address21 Ortho LnAtlanta, GA 30329-2315
Phone(404) 778-2516
Sole ProprietorNo
Enumeration DateApril 23, 2025
Last NPPES UpdateJuly 17, 2026
NPPES CertifiedJuly 17, 2026
✔ NPI 1063209864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
21 ORTHO LANE, Atlanta, GA 30329
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Other Names 1

Other Name (5)Bo Worden

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Worden is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

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

JUAN CARLOS TELLEZ MD
Orthopaedic Surgery
21 ORTHO LANE, SOM SUITE/5TH FLOOR
ATLANTA, GA 30329
Dekalb County (404) 778-2516

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 Jacob Worden's NPI number?

The NPI number for Jacob Worden is 1063209864. It was assigned to this individual provider in the NPPES registry on April 23, 2025. The provider is also known as Bo Worden.

Where is Jacob Worden located?

Jacob Worden practices at 21 Ortho Lane Som Suite/5th Floor, Atlanta, GA 30329. The listed phone number is (404) 778-2516.

What is Jacob Worden's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jacob Worden enrolled in Medicare?

Yes. Jacob Worden is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Worden was last updated on July 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days 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.