Active NPI
Jasmine Pacheco
- Personal Care Attendant
- New London, CT
National Provider Identifier
1174071062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- NA9989861
- Practice address
- 90 Ledge Rd
New London, CT 06320-2514 - Phone
- (203) 802-2598
- NPI assigned
- Sep 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | NA9989861 | CT | Primary |
Addresses
Primary practice location
90 Ledge Rd
New London, CT 06320-2514
Mailing address
90 Ledge Rd
New London, CT 06320-2514
Phone (203) 802-2598
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
| License | State | Type | Specialty |
|---|---|---|---|
| NA9989861 | CT | MD | Personal Care Attendant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474329600000",
"number": "1174071062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 LEDGE RD",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063202514",
"telephone_number": "203-802-2598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 LEDGE RD",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063202514",
"telephone_number": "203-802-2598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACHECO",
"first_name": "JASMINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-20",
"last_updated": "2016-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "CT",
"license": "NA9989861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New London, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.