Individual provider Active NPI

Jasmine Shante' Roberson, APRN

  • Gerontology Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1427718022
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
30570 Issued in TN
Practice address
2245 S Lauderdale St
Memphis, TN 38106-7517
Phone
(901) 948-5558
NPI assigned
Dec 22, 2021
Last updated
Dec 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 30570 TN Primary

Addresses

Primary practice location

2245 S Lauderdale St
Memphis, TN 38106-7517

Mailing address

4302 John Wood LN
Olive Branch, MS 38654-9836
Phone (662) 397-7470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220211000129 TN Practitioner - Nurse Practitioner 3072906262 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Physician Network, LLCGroup PAC ID 2365701943, 74 clinicians

Practice addresses (Care Compare)

2996 Kate Bond Rd
Suite 305
Memphis, TN 38133-4063
Phone (901) 300-2971

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.82 of 100Reported as group
Quality
69.44
Promoting interoperability
100
Improvement activities
40
Cost
83.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
30570TNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Physician Network, LLC CurrentSince May 2, 2024 Accepting new patients
Midsouth Independent Group, PLLC CurrentSince Jan 1, 2022 Accepting new patients
Phillip R. Bowden, M.D.,P.a. CurrentSince Oct 15, 2023 Accepting new patients
Health 360 PLLC CurrentSince Jan 21, 2024 Accepting new patients
MSK Group, PC PastSince May 2, 2024 Accepting new patients

Locations

2996 Kate Bond Rd
Ste 305
Bartlett, TN 38133
Phone (901) 300-2971

1417 Monroe Ave
Memphis, TN 38104
Phone (901) 272-7200

1717 Kirby Pkwy
Memphis, TN 38120
Phone (901) 272-7200

2245 S Lauderdale St
Memphis, TN 38106
Phone (901) 582-7660

6005 Park Ave
Ste 601
Memphis, TN 38119
Phone (901) 680-9205

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1427718022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 JOHN WOOD LN",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386549836",
            "telephone_number": "662-397-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 S LAUDERDALE ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381067517",
            "telephone_number": "901-948-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "JASMINE",
        "middle_name": "SHANTE'",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-22",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "30570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.