Organization Active NPI

Jasper Health Services Florida LLC

  • Clinical Social Worker
  • Altamonte Springs, FL
National Provider Identifier
1114788288
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
JASPER HEALTH SERVICES FLORIDA LLC
Practice address
235 N Westmonte Dr
1St and 2ND Floor
Altamonte Springs, FL 32714-3345
Phone
(929) 552-3904
Fax
(877) 254-0980
NPI assigned
Jan 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Authorized official

Name
Greg Orr
Title
Coo
Phone
(702) 419-5668

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

235 N Westmonte Dr
1St and 2ND Floor
Altamonte Springs, FL 32714-3345

Mailing address

235 N Westmonte Dr
1St and 2ND Floor
Altamonte Springs, FL 32714-3345
Phone (929) 552-3904

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://healthcare.googleapis.com/v1/projects/jasper-health/locations/us/datasets/Jasper-Health/fhirStores/Direct2Consumer/fhi Direct Jasper Health, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240311002698 FL Part B Supplier - Clinic/Group Practice 7113363342 Receives reassigned benefits from 2 practitioners
Practice locations: Altamonte Springs, FL; Orange Park, FL
O20241206003140 VA Part B Supplier - Clinic/Group Practice 7113363342 Practice locations: Mechanicsville, VA

National Provider Directory

National Provider Directory

Locations

4210 Valley Ridge Blvd
Ste 135
Ponte Vedra, FL 32081
Phone (929) 552-3904

7288 Hanover Green Dr
Ste A
Mechanicsville, VA 23111
Phone (201) 676-2579

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1114788288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 N WESTMONTE DR",
            "address_2": "1ST AND 2ND FLOOR",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327143345",
            "telephone_number": "929-552-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N WESTMONTE DR",
            "address_2": "1ST AND 2ND FLOOR",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327143345",
            "telephone_number": "929-552-3904",
            "fax_number": "877-254-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASPER HEALTH SERVICES FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "ORR",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "702-419-5668"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://healthcare.googleapis.com/v1/projects/jasper-health/locations/us/datasets/Jasper-Health/fhirStores/Direct2Consumer/fhi",
            "affiliation": "Y",
            "endpointDescription": "R4 FHIR API",
            "affiliationName": "Jasper Health, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "JSON (FHIR)",
            "address_1": "950 W Bannock St Ste 1100",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837026140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.