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

Mr. Jacob Smith, PA-C, ATC

Individual provider Medical Physician Assistant · NPI 1548675945

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?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

1111 Trinity Ln Ste 111
Bloomington, IL 61704-8112
Phone: (309) 663-6461
Show map & directions

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 number1548675945
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C , ATC
Sole proprietorYes
NPI enumeratedJune 24, 2014
Last updated in NPPESMarch 30, 2022
Certification dateMarch 22, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Carle Health Care Incorporated — 1543 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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