CLYDE TYRONE JACOB III M.D.
NPI 1972504488
Obstetrics & Gynecology in Johns Creek, GA
About Clyde Tyrone Jacob Iii M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CLYDE TYRONE JACOB III M.D. (NPI 1972504488) is an individual obstetrics & gynecology provider in Johns Creek, Georgia, licensed in Georgia (81399) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Tampa, and maintains a secondary practice location in Austell.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Clyde Tyrone Jacob Iii M.d. 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.
Medicare Billing Reassignments
10Medicare enrollment records show Clyde Jacob reassigns Medicare billing to 10 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Atlanta, GA 30322
- Reassigned Medicare billing, Georgia enrollment
- 4,840 clinicians in this Medicare group
Athens, GA 30606
- Reassigned Medicare billing, Georgia enrollment
- 208 clinicians in this Medicare group
Fayetteville, GA 30214
- Reassigned Medicare billing, Georgia enrollment
- 67 clinicians in this Medicare group
Little Rock, AR 72205
- Reassigned Medicare billing, Arkansas enrollment
- 62 clinicians in this Medicare group
Mangonia Park, FL 33407
- Reassigned Medicare billing, Florida enrollment
- 237 clinicians in this Medicare group
Salisbury, MD 21801
- Reassigned Medicare billing, Maryland enrollment
- 27 clinicians in this Medicare group
Seaford, DE 19973
- Reassigned Medicare billing, Delaware enrollment
- 27 clinicians in this Medicare group
Edison, NJ 08820
- Reassigned Medicare billing, New Jersey enrollment
- 55 clinicians in this Medicare group
Seattle, WA 98104
- Reassigned Medicare billing, Washington enrollment
- 129 clinicians in this Medicare group
Silverdale, WA 98383
- Reassigned Medicare billing, Washington enrollment
- 223 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Adventhealth Tampa
Acute Care Hospitals · Tampa, FLPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30097 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
JOHNS CREEK, GA 30097
JOHNS CREEK, GA 30097
JOHNS CREEK, GA 30097
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 Clyde Jacob's NPI number?
The NPI number for Clyde Jacob is 1972504488. It was assigned to this individual provider in the NPPES registry on August 9, 2005.
Where is Clyde Jacob located?
Clyde Jacob practices at 6325 Hospital Pkwy, Johns Creek, GA 30097. The listed phone number is (678) 474-7000.
What is Clyde Jacob's specialty?
The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.
Is Clyde Jacob enrolled in Medicare?
Yes. Clyde Jacob 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.
Which organizations bill Medicare for Clyde Jacob's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Clyde Jacob reassigns Medicare benefits to 10 organizations: The Emory Clinic Inc (Atlanta, GA), Obhg Georgia, P.C. (Athens, GA), Dhp Of Piedmont PC (Fayetteville, GA), Dhp Of Arkansas PA (Little Rock, AR), Dhp Of Manatee PA (Mangonia Park, FL) and 5 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Clyde Jacob's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Clyde Jacob accept?
Health plans from Alliant Health Plans, Inc., Health Advantage, Octave and Providence Health Plan list Clyde Jacob 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 Clyde Jacob affiliated with any hospitals?
According to CMS data, Clyde Jacob is affiliated with Adventhealth Tampa.
When was this NPI record last updated?
The NPPES record for Clyde Jacob was last updated on October 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Clyde Tyrone Jacob III, M.D. · NPI 1972504488
Obstetrics & Gynecology physician in Johns Creek, Georgia. Individual provider, active in the CMS NPPES registry since August 9, 2005.
## Identity
- **NPI:** 1972504488 (Entity type: Individual)
- **Enumerated:** August 9, 2005
- **Primary specialty:** Obstetrics & Gynecology · taxonomy 207V00000X
- **State license:** 81399 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 6325 HOSPITAL PKWY, Johns Creek, GA 30097-5775
- **Phone:** (678) 474-7000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 10 organizations under Medicare reassignment (form CMS-855R): The Emory Clinic Inc (NPI 1396798229, Atlanta, GA); Obhg Georgia, P.C. (NPI 1750686838, Athens, GA); Dhp Of Piedmont PC (NPI 1316202609, Fayetteville, GA); Dhp Of Arkansas PA (NPI 1992068878, Little Rock, AR); Dhp Of Manatee PA (NPI 1134771611, Mangonia Park, FL); and 5 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1993
## Record status
- **NPPES last updated:** October 22, 2026
- **Other identifiers:** Medicaid 02219496 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1972504488) · Data from the CMS NPPES public registry.