Mr. Jacob Smith, PA-C, ATC
Mr. Jacob Smith, PA-C, ATC is a Physician Assistant in Bloomington, Illinois. Qualified in 2021, 5 years ago. Practices with Carle Health Care Incorporated, a 1,543-clinician group and accepts Medicare assignment. Licensed in Illinois.
- Years since qualifying
- 5
- Licensed in
- IL
- In the registry since
- 2014
- Specialties on file
- 2
What do these letters mean?
Practice location Address checks out
1111 Trinity Ln Ste 111Bloomington, IL 61704-8112
Phone: (309) 663-6461
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 085008559 (IL) |
|---|---|
| Medical Physician Assistant | Taxonomy 363AM0700X · Licence 085008559 (IL) |
Record details
| NPI number | 1548675945 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PA-C , ATC |
| Sole proprietor | Yes |
| NPI enumerated | June 24, 2014 |
| Last updated in NPPES | March 30, 2022 |
| Certification date | March 22, 2022 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2021 (5 years in practice) |
| Group practice | Carle Health Care Incorporated — 1543 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 5 on file with Medicare |
Other providers in Bloomington
-
Mrs. Flora Leatrice Adams-Williams, PA-C
1523 Lafayette Park Dr Unit 6, Bloomington, IL 61701-6800 · (217) 365-7928
-
Elizabeth Ardith Wilson, PA-C
2204 Eastland Dr, Bloomington, IL 61704-3567 · (309) 661-6900