Individual provider Active NPI

Jacqueline Nicole Sniffen, MSN, APRN, FNP-BC

  • Primary Care Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1326637901
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95016779 Issued in CA
Practice address
4212 Maryland St Apt 5
San Diego, CA 92103-2343
Phone
(214) 240-4116
NPI assigned
Jan 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95234286 CA
Primary Care Nurse Practitioner 363LP2300X 95016779 CA Primary

Addresses

Primary practice location

4212 Maryland St Apt 5
San Diego, CA 92103-2343

Mailing address

4212 Maryland St Apt 5
San Diego, CA 92103-2343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210511002781 CA Practitioner - Nurse Practitioner 3476962044 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Home Physicians Medical Group, Inc. CurrentSince May 5, 2021 Accepting new patients

Locations

4849 Ronson Ct
Ste 217
San Diego, CA 92111
Phone (858) 279-1212

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10731/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1326637901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 MARYLAND ST APT 5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 MARYLAND ST APT 5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032343",
            "telephone_number": "214-240-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIFFEN",
        "first_name": "JACQUELINE",
        "middle_name": "NICOLE",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95234286",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95016779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.