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JACOB GRISHAM FNP
NPI 1417776196
Nurse Practitioner - Family in Newburgh, IN

Active since October 09, 2024PECOS EnrolledAccepts Medicare Assignment
3800 VENETIAN WAY, NEWBURGH, IN 47630(812) 477-6103(812) 469-3285 Get Directions Write a Review

NPPES record last updated: May 13, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 13, 2025, Oct 9, 2024 (2 updates tracked since 2024).

About Jacob Grisham Fnp NPPES

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

JACOB GRISHAM FNP (NPI 1417776196) is an individual family provider in Newburgh, Indiana, licensed in Indiana (71015844A) and active in the NPI registry since October 2024. He is enrolled in Medicare PECOS, is affiliated with Deaconess Hospital Inc, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1417776196
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJACOB GRISHAMCredential: FNP
Location Address3800 VENETIAN WAYNewburgh, IN 47630-8257
Mailing Address3800 Venetian WayNewburgh, IN 47630-8257 · (812) 477-6103
Phone(812) 477-6103
Fax(812) 469-3285
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateOctober 9, 2024
Last NPPES UpdateMay 13, 20252 updates tracked since enumeration
NPPES CertifiedMay 7, 2025
✔ NPI 1417776196 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 IN · 71015844A
3800 VENETIAN WAY, Newburgh, IN 47630
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacob Grisham Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638604879
PECOS Enrollment IDI20241125001024
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.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Deaconess Hospital Inc

Acute Care Hospitals · Evansville, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150082
Location600 Mary StEvansville, IN 47710 · Vanderburgh County
Emergency services

Ascension St Vincent Evansville

Acute Care Hospitals · Evansville, IN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150100
Location3700 Washington AveEvansville, IN 47750 · Vanderburgh County
Emergency services Birthing friendly

Ascension St Vincent Warrick

Critical Access Hospitals · Boonville, IN
OwnershipVoluntary non-profit - Private
CMS Certification Number151325
Location1116 Millis AveBoonville, IN 47601 · Warrick County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47630 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

SCARLETT CAO MD
Internal Medicine
3800 VENETIAN WAY
NEWBURGH, IN 47630
Warrick County (812) 477-6103
LADONNA M SCHMIDT ACNP
Nurse Practitioner (Acute Care)
3800 VENETIAN WAY, STE 200
NEWBURGH, IN 47630
Warrick County (812) 477-6103
PAUL KOZAK DO
Internal Medicine (Gastroenterology)
3800 VENETIAN WAY
NEWBURGH, IN 47630
Warrick County (812) 477-6103
ABBY ELIZABETH DOSSETT AG-ACNP
Nurse Practitioner (Acute Care)
3800 VENETIAN WAY, STE 200
NEWBURGH, IN 47630
Warrick County (812) 477-6103
DIGESTIVE CARE OF EVANSVILLE, PC
Non-Pharmacy Dispensing Site
3800 VENETIAN WAY
NEWBURGH, IN 47630
Warrick County (812) 477-6103
DR. VAJRAVEL M. PRASAD MD
Internal Medicine (Gastroenterology)
3800 VENETIAN WAY, STE 200
NEWBURGH, IN 47630
Warrick County (812) 477-6103
KRISTA LAND NP-C
Nurse Practitioner (Family)
3800 VENETIAN WAY, STE 200
NEWBURGH, IN 47630
Warrick County (812) 477-6103
KONSTANTIN BORODA M.D.
Internal Medicine (Gastroenterology)
3800 VENETIAN WAY, STE 200
NEWBURGH, IN 47630
Warrick County (812) 266-2933

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 Grisham's NPI number?

The NPI number for Jacob Grisham is 1417776196. It was assigned to this individual provider in the NPPES registry on October 9, 2024.

Where is Jacob Grisham located?

Jacob Grisham practices at 3800 Venetian Way, Newburgh, IN 47630. The listed phone number is (812) 477-6103.

What is Jacob Grisham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jacob Grisham enrolled in Medicare?

Yes. Jacob Grisham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jacob Grisham accept?

Health plans from CareSource list Jacob Grisham 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.

Is Jacob Grisham affiliated with any hospitals?

According to CMS data, Jacob Grisham is affiliated with Deaconess Hospital Inc, Ascension St Vincent Evansville and Ascension St Vincent Warrick.

When was this NPI record last updated?

The NPPES record for Jacob Grisham was last updated on May 13, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.