Jazmin Baca

Primary specialty

Emergency Registered NurseTaxonomy code 163WE0003X

License

041.547572 Issued in IL

Practice address

128 Bertram Dr Unit K
Yorkville, IL 60560-3210

Phone

(915) 861-2616

NPI assigned

Jan 21, 2025

Last updated

Jan 21, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1255143939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 BERTRAM DR UNIT K",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605603210",
            "telephone_number": "915-861-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 BERTRAM DR UNIT K",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605603210",
            "telephone_number": "915-861-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACA",
        "first_name": "JAZMIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "IL",
            "license": "041.547572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emergency Registered Nurse in Yorkville, IL
• Providers in Yorkville, IL by specialty
• Emergency Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.