Individual provider Active NPI

Ousman Pen-Victoria Jassey

  • Registered Nurse
  • South Hill, VA
National Provider Identifier
1619213295
Registry record updated Dec 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
254-276 Issued in NC
Practice address
125 Buena Vista Cir
South Hill, VA 23970-1431
Phone
(434) 447-3151
NPI assigned
Dec 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 254-276 NC Primary

Addresses

Primary practice location

125 Buena Vista Cir
South Hill, VA 23970-1431

Mailing address

4015 Kilkenny Ave
Oxford, NC 27565-6976
Phone (919) 604-4520

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
254-276NCMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1356825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356825600000",
    "number": "1619213295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 KILKENNY AVE",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275656976",
            "telephone_number": "919-604-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BUENA VISTA CIR",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239701431",
            "telephone_number": "434-447-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASSEY",
        "first_name": "OUSMAN",
        "middle_name": "PEN-VICTORIA",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-30",
        "last_updated": "2012-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "254-276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Hill, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2012; 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.