Individual provider Active NPI

Jasmine C Porter, NP

  • Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1043980717
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71011633A Issued in IN
Practice address
3700 Washington Ave Ste 1100
Evansville, IN 47714-0541
Phone
(812) 485-1894
NPI assigned
Sep 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71011633A IN Primary

Addresses

Primary practice location

3700 Washington Ave Ste 1100
Evansville, IN 47714-0541

Mailing address

3700 Washington Ave Ste 1100
Evansville, IN 47714-0541

Other practice location 1

4506 1st Ave
Evansville, IN 47710-3624
Phone (812) 482-6161

Other names 1

  • Jasmine C Harrell Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jasmine.porter.1@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211004003114 IN Practitioner - Nurse Practitioner 5496153520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

3700 Washington Ave
Suite 1100
Evansville, IN 47714-0541
Phone (812) 473-1111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71011633AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary's Medical Group, LLC CurrentSince Feb 6, 2022 Accepting new patients
St Mary's Medical Group, LLC Nurse Practitioner CurrentSince Feb 6, 2022 Accepting new patients
St. Mary's Health, Inc Nurse Practitioner Past Accepting new patients

Locations

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

3700 Washington Ave
Ste 1100
Evansville, IN 47714
Phone (812) 469-8170

3700 Washington Ave
#1100
Evansville, IN 47714
Phone (812) 471-0045

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

Organizations & group practices 3

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": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1043980717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE STE 1100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE STE 1100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140541",
            "telephone_number": "812-485-1894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4506 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477103624",
            "country_code": "US",
            "telephone_number": "812-482-6161",
            "fax_number": "812-421-2883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JASMINE",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71011633A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jasmine.porter.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "3700 Washington Ave Ste 1100",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477140541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JASMINE",
            "last_name": "HARRELL",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.