DR. MARYANN KURUVILLA JACOB M.D.
NPI 1356375315
Psychiatry & Neurology - Child & Adolescent Psychiatry in Atlanta, GA

Q: What is Maryann Jacob's NPI number?

The NPI number for Maryann Jacob is 1356375315. It was assigned to this individual provider in the NPPES registry on July 10, 2006.

Q: What is Maryann Jacob's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Q: When was this NPI record last updated?

The NPPES record for Maryann Jacob was last updated on December 8, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 10, 2006PECOS Enrolled

1001 JOHNSON FERRY RD, ATLANTA, GA 30342(404) 785-4982 Get Directions Write a Review

NPPES record last updated: December 8, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Maryann Kuruvilla Jacob M.d. NPPES

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

DR. MARYANN KURUVILLA JACOB M.D. (NPI 1356375315) is an individual child & adolescent psychiatry provider in Atlanta, Georgia, licensed in Georgia (058562) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356375315

Entity TypeIndividualFemale

Primary Taxonomy2084P0804X

Provider Legal NameDR. MARYANN KURUVILLA JACOBCredential: M.D.

Location Address1001 JOHNSON FERRY RDAtlanta, GA 30342-1605

Mailing Address1401 Arnold Ave NeAtlanta, GA 30324-4621 · (678) 662-0288

Phone(404) 785-4982

Sole ProprietorYes

Enumeration DateJuly 10, 2006

Last NPPES UpdateDecember 8, 2023

NPPES CertifiedDecember 8, 2023

✔ NPI 1356375315 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

Licenses✔ Licensed in GA · 058562✔ Licensed in MI · 4301086452

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

1001 JOHNSON FERRY RD, Atlanta, GA 30342

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Maryann Kuruvilla Jacob M.d. 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.

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Other Providers at the Same Location NPPES 20

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

AMBER MCMILLIAN BORDERS CPNP

Nurse Practitioner (Pediatrics)