1. Home
  2. Directory
  3. Georgia
  4. Fort Gordon
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

DR. BONAMICO PORTER JACOBS MD
NPI 1699448597
Student in an Organized Health Care Education/Training Program in Fort Gordon, GA

Active since July 27, 2021PECOS Enrolled
ORTHOPAEDIC SURGERY RESIDENCY PROGRAM, DDEAMC, 300 EAST HOSPITAL ROAD, FORT GORDON, GA 30905(706) 787-1647 Get Directions Write a Review

NPPES record last updated: February 21, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 21, 2023, Jul 27, 2021 (2 updates tracked since 2021).

About Dr. Bonamico Porter Jacobs Md NPPES

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

DR. BONAMICO PORTER JACOBS MD (NPI 1699448597) is an individual student in an organized health care education/training program in Fort Gordon, Georgia, licensed in Georgia (94708) and active in the NPI registry since July 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699448597
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. BONAMICO PORTER JACOBSCredential: MD
Location AddressORTHOPAEDIC SURGERY RESIDENCY PROGRAM, DDEAMC, 300 EAST HOSPITAL ROADFort Gordon, GA 30905-5650
Mailing Address300 East Hospital RoadFort Gordon, GA 30905-5650
Phone(706) 787-1647
Sole ProprietorNo
Enumeration DateJuly 27, 2021
Last NPPES UpdateFebruary 21, 20232 updates tracked since enumeration
NPPES CertifiedFebruary 21, 2023
✔ NPI 1699448597 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
License✔ Licensed in GA · 94708
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.
ORTHOPAEDIC SURGERY RESIDENCY PROGRAM, Fort Gordon, GA 30905
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)

Dr. Bonamico Porter Jacobs Md 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 Bonamico Jacobs's NPI number?

The NPI number for Bonamico Jacobs is 1699448597. It was assigned to this individual provider in the NPPES registry on July 27, 2021.

Where is Bonamico Jacobs located?

Bonamico Jacobs practices at Orthopaedic Surgery Residency Program Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905. The listed phone number is (706) 787-1647.

What is Bonamico Jacobs's specialty?

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

Is Bonamico Jacobs enrolled in Medicare?

Yes. Bonamico Jacobs is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bonamico Jacobs was last updated on February 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.