Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jacob Randall Lassiter, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1295178580

Dr. Jacob Randall Lassiter, MD is an Obstetrics/Gynecology in Crestview, Florida. Qualified in 2013, 13 years ago. Practices with North Okaloosa Clinic Corp, a 25-clinician group and accepts Medicare assignment. Licensed in Alabama, Florida and Mississippi.

Years since qualifying
13
Licensed in
AL, FL, MS
In the registry since
2013
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

550 Redstone Ave W Ste 470
Crestview, FL 32536-6457
Phone: (850) 689-2229
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence ME140756 (FL)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 24652 (MS)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence MD.34009 (AL)

Record details

NPI number1295178580
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 17, 2013
Last updated in NPPESNovember 10, 2021
Certification dateNovember 10, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice North Okaloosa Clinic Corp — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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