Individual provider Active NPI

Jacel Watkins-Ali, RN

  • Registered Nurse
  • New York, NY
National Provider Identifier
1396462172
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R193708 Issued in MD
Practice address
233 Sprint St.
Floor 13
New York, NY 10013
Phone
(212) 651-8200
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R193708 MD Primary

Addresses

Primary practice location

233 Sprint St.
Floor 13
New York, NY 10013

Mailing address

4050 Piedmont Pkwy
High Point, NC 27265-9458
Phone (212) 651-8200

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R193708MDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Active Health Management, Inc. CurrentSince Oct 30, 2022 Accepting new patients

Locations

4050 Piedmont Pkwy
High Point, NC 27265
Phone (336) 289-8648

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": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1396462172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 PIEDMONT PKWY",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659458",
            "telephone_number": "212-651-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 SPRINT ST.",
            "address_2": "FLOOR 13",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10013",
            "telephone_number": "212-651-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS-ALI",
        "first_name": "JACEL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R193708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.