Jared Andrew Mort, APRN, CNS

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

License

11004509 Issued in FL

Practice address

2792 Rhett Dr
Beavercreek, OH 45434-6259

Phone

(210) 488-8143

NPI assigned

Oct 17, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist

State licenses

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1538701933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2792 RHETT DR",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346259",
            "telephone_number": "210-488-8143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2792 RHETT DR",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454346259",
            "telephone_number": "210-488-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORT",
        "first_name": "JARED",
        "middle_name": "ANDREW",
        "credential": "APRN, CNS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "FL",
            "license": "11004509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BOARD OF NURSING APRN LICENSE AS A CLINICAL NURSE SPECIALIST",
            "identifier": "11004509",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Michele Moore
• Matthew D Moore, MD
• Deborah Lynn Mooty, QMHS/CMS
• Justin Moran, DO
• More From Life Therapy LLC
• Seth Ian Morton, DPT
• Sandie Faith Moseley
• Brandon Lee Mosely, AG-ACNP
• Jonathan Paul Mosora, PHARMD
• Steven Motter

• Gerontology Clinical Nurse Specialist in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Gerontology Clinical Nurse Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; 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.