Individual provider Active NPI

Jerri Sow

  • Licensed Practical Nurse
  • College Station, TX
National Provider Identifier
1407393606
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
P322911 Issued in MS
Practice address
18072 Ranch House Rd
College Station, TX 77845-3494
Phone
(601) 955-2100
NPI assigned
Jan 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X P322911 MS Primary

Addresses

Primary practice location

18072 Ranch House Rd
College Station, TX 77845-3494

Mailing address

8950 Glencrest St Apt 8222
Houston, TX 77061-3065
Phone (601) 955-2100

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

State licenses

LicenseStateTypeSpecialty
P322911MSMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1407393606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 GLENCREST ST APT 8222",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770613065",
            "telephone_number": "601-955-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18072 RANCH HOUSE RD",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778453494",
            "telephone_number": "601-955-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOW",
        "first_name": "JERRI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MS",
            "license": "P322911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.