Active NPI
Jasamine Brittanie Kola-Korolo, N.P.
- Nurse Practitioner
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1113530
- Practice address
- 701 Olympic Plaza Cir
Tyler, TX 75701-1950 - Phone
- (903) 596-3627
- NPI assigned
- Aug 28, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1113530 | TX | Primary |
Addresses
Primary practice location
701 Olympic Plaza Cir
Tyler, TX 75701-1950
Mailing address
701 Olympic Plaza Cir
Tyler, TX 75701-1950
Phone (903) 596-3627
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 590-5611
18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292
Hospital & facility affiliations
- Ut Health East Texas Tyler Regional Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1113530 | TX | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Etmc Physician Group Inc. | Current | Accepting new patients | |
| Etmc Physician Group Inc. | Current | Accepting new patients | |
| Radiology Associates of North Texas PA | Past | Accepting new patients |
Locations
18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292
1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068
1000 E 5th St
Ste 100
Tyler, TX 75701
Phone (903) 590-5000
701 Olympic Plaza Cir
Tyler, TX 75701
Phone (903) 596-3236
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Tyler, TX
- NPI 1609382662
-
- Rural Health Clinic/Center
- Chandler, TX
- NPI 1235706581
-
- Diagnostic Radiology Physician
- Fort Worth, TX
- NPI 1710970975
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tyler, TX
- NPI 1407364847
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693180800000",
"number": "1245015353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 OLYMPIC PLAZA CIR",
"city": "TYLER",
"state": "TX",
"postal_code": "757011950",
"telephone_number": "903-596-3627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 OLYMPIC PLAZA CIR",
"city": "TYLER",
"state": "TX",
"postal_code": "757011950",
"telephone_number": "903-596-3627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLA-KOROLO",
"first_name": "JASAMINE",
"middle_name": "BRITTANIE",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-28",
"last_updated": "2023-08-28",
"certification_date": "2023-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "1113530",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.