Individual provider Active NPI

Jigna Mistry, FNP

  • Student in an Organized Health Care Education/Training Program
  • San Jose, CA
National Provider Identifier
1124267489
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
17955 Issued in CA
Practice address
1835 Cunningham Ave
San Jose, CA 95122-1712
Phone
(408) 347-5988
Fax
(408) 347-6019
NPI assigned
Feb 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 17955 CA Primary

Addresses

Primary practice location

1835 Cunningham Ave
San Jose, CA 95122-1712

Mailing address

5671 Santa Teresa Blvd
Suite 105
San Jose, CA 95123-6512
Phone (408) 284-2281

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
17955CAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234224000000",
    "number": "1124267489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5671 SANTA TERESA BLVD",
            "address_2": "SUITE 105",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951236512",
            "telephone_number": "408-284-2281",
            "fax_number": "408-281-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 CUNNINGHAM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951221712",
            "telephone_number": "408-347-5988",
            "fax_number": "408-347-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "JIGNA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-10",
        "last_updated": "2009-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "17955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; 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.