MRS. CHERYL ANN JACOBS (CPNP) – Pediatric Nurse Practitioner, NPI 1790939924
Pediatric Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
14,989 NURSE PRACTITIONER in OH
Provider Addresses for MRS. CHERYL ANN JACOBS (CPNP)
1037 Conneaut Ave
Suite 203
Bowling Green, OH 434025301
Phone: (419) 354-3295
Fax: (419) 354-3297
Type: Location
745, Haskins Road, Boom Town Historic District, Quail Hollow, Bowling Green, Wood County, Ohio, 43402, United States
SUITE B
BOWLING GREEN, OH 434021600
Phone: (419) 373-7607
Fax: (419) 353-7076
Type: Mailing
1037, Conneaut Avenue, Foxgate Farm, Bowling Green, Wood County, Ohio, 43402, United States
SUITE 203
BOWLING GREEN, OH 434025301
Phone: (419) 354-3295
Fax: (419) 354-3297
Type: Location
970 W WOOSTER ST RM 130
BOWLING GREEN, OH 434022652
Phone: (419) 352-6890
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 48 Open Payments records for all available years, with a total value of $1,049.
Total Amount is formed as General ($1,049) + Research ($0) + Ownership ($0) = $1,049.
Last reported payment date: 2024-10-22 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($393).
Total Amount
$1,049
General + Research + Ownership
Payments
48
Total payment records
General Amount
$1,049
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Supernus Pharmaceuticals, Inc. | $393 |
| Corium, LLC | $211 |
| Ironshore Pharmaceuticals Inc. | $162 |
| IRONSHORE PHARMACEUTICALS INC. | $135 |
| Seqirus USA Inc | $87 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2009-09-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090916000565 | I | Nurse Practitioner | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 43402)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Family Practice | OH | |
| Sports Medicine, Family Practice | OH | |
| - | OH | |
| - | OH | |
| - | OH | |
| General Surgery | OH | |
| Physician Assistant | OH |
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