Jazmine Collins, DOM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC01964 Issued in TX

Practice address

5305 McNutt Rd Ste 204
Santa Teresa, NM 88008-9605

Phone

(512) 893-3376

NPI assigned

May 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• SJC Medical Group LLC

  dba Bloom Traditional Medicine

  • Clinic/Center
  • Kyle, TX
  • NPI 1174230866
  NPD Authorized official

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1386267102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 SPINNAKER LOOP",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786402598",
            "telephone_number": "512-893-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 MCNUTT RD STE 204",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089605",
            "telephone_number": "512-893-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Kirkham Cir # B",
            "address_purpose": "LOCATION",
            "city": "Kyle",
            "state": "TX",
            "postal_code": "786409703",
            "country_code": "US",
            "telephone_number": "512-893-3376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JAZMINE",
        "credential": "DOM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NM",
            "license": "DOM1271",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP4348",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "AC01964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mireya Grisel Cepeda, LCSW
• Dulce Estela Chairez Parra
• Sarah Chance
• Carlos David Cheda
• CM Mental Health Services LLC
• Anahi Contreras
• Mayra A Contreras
• Sonia Leticia Contreras
• Jacob Cosio
• Jennifer C Croom, OTR

• Acupuncturist in Santa Teresa, NM
• Providers in Santa Teresa, NM by specialty
• Acupuncturist in New Mexico

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