Individual provider Active NPI

Jasmin Amon Moore

  • Case Manager/Care Coordinator
  • Tulsa, OK
National Provider Identifier
1235875121
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
551 N 28TH West Ave
Tulsa, OK 74127-6139
Phone
(918) 794-0197
NPI assigned
May 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

551 N 28TH West Ave
Tulsa, OK 74127-6139

Mailing address

1276 W Queen St
Tulsa, OK 74127-2502
Phone (918) 619-2102

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

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1235875121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 W QUEEN ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741272502",
            "telephone_number": "918-619-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 N 28TH WEST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741276139",
            "telephone_number": "918-794-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JASMIN",
        "middle_name": "AMON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.