Individual provider Active NPI

Jessica Anne Mukherjee

  • Nurse Practitioner
  • Bethesda, MD
National Provider Identifier
1407272396
Registry record updated Aug 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R215265 Issued in MD
Practice address
6420 Rockledge Dr
Suite 4200
Bethesda, MD 20817-7837
Phone
(301) 424-6231
NPI assigned
Mar 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 657487-1 NY
Nurse Practitioner 363L00000X R215265 MD Primary
Registered Nurse 163W00000X R215265 MD

Addresses

Primary practice location

6420 Rockledge Dr
Suite 4200
Bethesda, MD 20817-7837

Mailing address

6420 Rockledge Dr
Suite 4200
Bethesda, MD 20817-7837

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
657487-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1394841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471737600000",
    "number": "1407272396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 ROCKLEDGE DR",
            "address_2": "SUITE 4200",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208177837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 ROCKLEDGE DR",
            "address_2": "SUITE 4200",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208177837",
            "telephone_number": "301-424-6231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKHERJEE",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-15",
        "last_updated": "2016-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "657487-1",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R215265",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R215265",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2016; 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.