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

Jacob D Bly

Individual provider Psychiatry Physician · NPI 1972183846

Jacob D Bly is a Psychiatry in Newark, Delaware. Graduated from University of Missouri, Kansas City, School of Medicine in 2021, 5 years ago. Practices with SSM Regional Health Services, a 166-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
5
Trained at
University of Missouri, Kansas City, School of Medicine
Licensed in
MO
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

4755 Olgetown Staton Rd
Newark, DE 19718-0001
Phone: (302) 733-1043
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 114 E South Hills Dr, Maryville, MO 64468-2659 — (660) 562-4305

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 2025044588 (MO)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1972183846
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 13, 2021
Last updated in NPPESNovember 17, 2025
Certification dateNovember 17, 2025
Mailing address4755 Olgetown Staton Rd, Newark, DE 19718-0001

Medicare enrollment

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

Medicare specialtyPSYCHIATRY
Medical schoolUNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice Ssm Regional Health Services — 166 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Newark