Jessica Lea Probert, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0003153 Issued in CO

Practice address

720 S Colorado Blvd PH North
Denver, CO 80246-1904

Phone

(415) 424-4266

Fax

(425) 520-6633

NPI assigned

Mar 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 9

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Telehealth Services USA

  • Pediatrics Physician
  • Truckee, CA
  • NPI 1275035263
  NPD (past)
• Telehealth Services USA

  • Clinical Social Worker
  • Truckee, CA
  • NPI 1386304228
  NPD (past)

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1598064149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 ESTERS BLVD STE 900",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632233",
            "telephone_number": "415-424-4266",
            "fax_number": "303-338-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S COLORADO BLVD PH NORTH",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461904",
            "telephone_number": "415-424-4266",
            "fax_number": "425-520-6633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4220 S Maryland Pkwy Bldg A2nd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891197533",
            "country_code": "US",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8300 Esters Blvd Ste 900",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750632233",
            "country_code": "US",
            "telephone_number": "415-424-4266",
            "fax_number": "303-338-0443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10775 Pioneer Trl Ste 215",
            "address_purpose": "LOCATION",
            "city": "Truckee",
            "state": "CA",
            "postal_code": "961610234",
            "country_code": "US",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROBERT",
        "first_name": "JESSICA",
        "middle_name": "LEA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8647",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58490",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115328",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14389",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11899",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2020031690",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2504",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0003153",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61097382",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pro Health One Inc
• Proactive Health, Inc
• Proactive Pediatrics, LLC
• Proaxis Denver, LLC
• Proaxis Employment Services, LLC
• Thomas Albert Probst, ATC, PT
• Allan V Prochazka, M.D., M.SC.
• Alexandra Prochniak, LPCC
• William Alexander Procter, M.S.
• Kailey D Proctor, DO

• Physician Assistant in Denver, CO
• Providers in Denver, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.