Jared L Rasmussen

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP10994 Issued in AZ

Practice address

103 E Medicine Way
Peridot, AZ 85542-8554

Phone

(928) 475-1400

NPI assigned

Mar 1, 2018

Last updated

Mar 1, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Carlos Apache Healthcare CorporationGroup PAC ID 0648580597, 147 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Carlos Apache Healthcare Corporation Hospital, Peridot, AZ, CCN 031320

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075

  TX

  Medicare reassignment Care Compare group NPD
• San Carlos Apache Healthcare Corporation

  dba Clarence Wesley Health Center

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713
  NPD
• The Fix Med Spa, PLLC

  • Family Medicine Physician
  • Safford, AZ
  • NPI 1043922131
  NPD (past)

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

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075
  Care Compare affiliation
• San Carlos Apache Healthcare Corporation

  dba Clarence Wesley Health Center

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1437651999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 W CHURCH ST",
            "city": "THATCHER",
            "state": "AZ",
            "postal_code": "855525644",
            "telephone_number": "928-965-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E MEDICINE WAY",
            "city": "PERIDOT",
            "state": "AZ",
            "postal_code": "855428554",
            "telephone_number": "928-475-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASMUSSEN",
        "first_name": "JARED",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-01",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marleah Olsen, RN
• Victor Cecilio Padron, PA
• Anthony T Patterson, CLINICAL PHARMACIST
• Anthony Robert Paul, FNP-C
• Leanne Samuiloff Pouremad, PHARMD
• Renal Dimensions, LLC (Renal Care Group San Carlos)
• San Carlos Apache Healthcare Corporation
• San Carlos Apache Healthcare Corporation
• San Carlos Apache Healthcare Corporation
• San Carlos Apache Healthcare Corporation

• Family Nurse Practitioner in Peridot, AZ
• Providers in Peridot, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.