Jasmyn Renee Berkley, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R216008 Issued in MD

Practice address

5524 Wesley Ave
Gwynn Oak, MD 21207-6824

Phone

(444) 204-4549

NPI assigned

Jul 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Jasmyn Renee Peterson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1184233488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5524 WESLEY AVE",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212076824",
            "telephone_number": "444-204-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5524 WESLEY AVE",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212076824",
            "telephone_number": "444-204-4549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKLEY",
        "first_name": "JASMYN",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R216008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASMYN",
            "last_name": "PETERSON",
            "middle_name": "RENEE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Gwynn Oak, MD
• Providers in Gwynn Oak, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.