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

Dr. Jacob Thomas Wilson, MD

Individual provider Family Medicine Physician · NPI 1245960509

Dr. Jacob Thomas Wilson, MD is a Family Practice in Daytona Beach, Florida. Qualified in 2022, 4 years ago. Practices with Halifax Healthcare Systems Inc, a 339-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
4
Licensed in
FL
In the registry since
2022
Specialties on file
2
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

201 N Clyde Morris Blvd Ste 200
Daytona Beach, FL 32114-2765
Phone: (386) 425-4165
Fax: (386) 425-7545
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence TRN35827 (FL)
Family Medicine Physician Taxonomy 207Q00000X · Licence ME166148 (FL)

Record details

NPI number1245960509
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 10, 2022
Last updated in NPPESNovember 19, 2024
Certification dateNovember 19, 2024

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Also practisesHOSPITALIST
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Halifax Healthcare Systems Inc — 339 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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