1. Home
  2. Directory
  3. Indiana
  4. South Bend
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

JACOB DALE GOOD
NPI 1194563734
Student in an Organized Health Care Education/Training Program in South Bend, IN

Active since July 17, 2024PECOS Enrolled
1118 ROBERTS ST, SOUTH BEND, IN 46615(574) 360-5826 Get Directions Write a Review

NPPES record last updated: July 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacob Dale Good NPPES

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

JACOB DALE GOOD (NPI 1194563734) is an individual student in an organized health care education/training program in South Bend, Indiana and active in the NPI registry since July 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194563734
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACOB DALE GOOD
Location Address1118 ROBERTS STSouth Bend, IN 46615-3909
Mailing Address1118 Roberts StSouth Bend, IN 46615-3909
Phone(574) 360-5826
Sole ProprietorNo
Enumeration DateJuly 17, 2024
NPPES CertifiedJuly 17, 2024
✔ NPI 1194563734 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.
1118 ROBERTS ST, South Bend, IN 46615
Open in Google Maps ↗

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 Dale Good 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.

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 Good's NPI number?

The NPI number for Jacob Good is 1194563734. It was assigned to this individual provider in the NPPES registry on July 17, 2024.

Where is Jacob Good located?

Jacob Good practices at 1118 Roberts St, South Bend, IN 46615. The listed phone number is (574) 360-5826.

What is Jacob Good'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 Good enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jacob Good was last updated on July 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.