Active NPI
Jade Ma Gates
- Student in an Organized Health Care Education/Training Program
- Flagstaff, AZ
National Provider Identifier
1396313508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 208 E Pine Knoll Dr
Flagstaff, AZ 86011-0001 - Phone
- (928) 523-5122
- NPI assigned
- Jun 14, 2021
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
208 E Pine Knoll Dr
Flagstaff, AZ 86011-0001
Mailing address
208 E Pine Knoll Dr
Flagstaff, AZ 86011
Phone (928) 523-5122
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": "1623628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740096000000",
"number": "1396313508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 E PINE KNOLL DR",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "86011",
"telephone_number": "928-523-5122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 E PINE KNOLL DR",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860110001",
"telephone_number": "928-523-5122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GATES",
"first_name": "JADE",
"middle_name": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-14",
"last_updated": "2025-02-21",
"certification_date": "2025-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.