Individual provider Active NPI

Jasmine Allegra Marotta-Jaenecke, CPM, LM

  • Midwife
  • Tucson, AZ
National Provider Identifier
1184946246
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
LM243 Issued in AZ
Practice address
3300 N Paseo de Los Rios Apt 14202
Tucson, AZ 85712-6086
Phone
(650) 393-9690
Fax
(866) 421-0311
NPI assigned
Feb 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X MW 60563122 WA
Midwife 176B00000X DEM-LD-10159323 OR
Midwife 176B00000X LM508 CA
Doula 374J00000X
Midwife 176B00000X LM243 AZ Primary

Addresses

Primary practice location

3300 N Paseo de Los Rios Apt 14202
Tucson, AZ 85712-6086

Mailing address

3300 N Paseo de Los Rios Apt 14202
Tucson, AZ 85712-6086
Phone (650) 393-9690

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
LM243AZMDMidwife
LM508CAMDMidwife
DEM-LD-10159323ORMDMidwife
MW 60563122WAMDMidwife

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1184946246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N PASEO DE LOS RIOS APT 14202",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126086",
            "telephone_number": "650-393-9690",
            "fax_number": "866-421-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 N PASEO DE LOS RIOS APT 14202",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126086",
            "telephone_number": "650-393-9690",
            "fax_number": "866-421-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAROTTA-JAENECKE",
        "first_name": "JASMINE",
        "middle_name": "ALLEGRA",
        "name_prefix": "Ms.",
        "credential": "CPM, LM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-17",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "WA",
            "license": "MW 60563122",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "OR",
            "license": "DEM-LD-10159323",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "LM508",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "AZ",
            "license": "LM243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.