Individual provider Active NPI

Xochitl Jaminet, RN

  • Addiction (Substance Use Disorder) Registered Nurse
  • Kenosha, WI
National Provider Identifier
1003590845
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
239040 Issued in WI
Practice address
3825 39TH Ave Ste 120
Kenosha, WI 53144-2043
Phone
(262) 946-5752
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 239040 WI Primary

Addresses

Primary practice location

3825 39TH Ave Ste 120
Kenosha, WI 53144-2043

Mailing address

3825 39TH Ave Ste 120
Kenosha, WI 53144-2043
Phone (262) 946-5752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
239040WIMDAddiction (Substance Use Disorder) Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Addiction Services and Pharmacotherapy, SC CurrentSince Jun 18, 2023 Accepting new patients

Locations

3825 39th Ave
Ste 120
Kenosha, WI 53144
Phone (262) 946-5752

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1003590845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 39TH AVE STE 120",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531442043",
            "telephone_number": "262-946-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 39TH AVE STE 120",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531442043",
            "telephone_number": "262-946-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMINET",
        "first_name": "XOCHITL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "239040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.