Individual provider Active NPI

Jocelyn Jasper, OWNER

  • Assisted Living Facility
  • Surprise, AZ
National Provider Identifier
1043921596
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL2591H Issued in AZ
Practice address
13387 W Fargo Dr
Surprise, AZ 85374-5206
Phone
(623) 546-5810
Fax
(623) 546-5810
NPI assigned
Dec 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL2591H AZ Primary

Addresses

Primary practice location

13387 W Fargo Dr
Surprise, AZ 85374-5206

Mailing address

13387 W Fargo Dr
Surprise, AZ 85374-5206
Phone (623) 546-5810

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL SURPRISE Direct

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

State licenses

LicenseStateTypeSpecialty
AL2591HAZMDAssisted Living Facility

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1043921596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13387 W FARGO DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745206",
            "telephone_number": "623-546-5810",
            "fax_number": "623-546-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13387 W FARGO DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745206",
            "telephone_number": "623-546-5810",
            "fax_number": "623-546-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASPER",
        "first_name": "JOCELYN",
        "credential": "OWNER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL2591H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SURPRISE",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13387 W Fargo Dr",
            "city": "Surprise",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853745206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.