Active NPI
Jesse Stoakes, PA-C, RD
- Physician Assistant
- Houston, TX
National Provider Identifier
1619383551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 6621 Fannin St
Houston, TX 77030-2358 - Phone
- (601) 320-3215
- NPI assigned
- Jul 10, 2014
- Last updated
- Dec 12, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | Primary | |
| Pediatric Nutrition Registered Dietitian | 133VN1004X | DT83282 | TX |
Addresses
Primary practice location
6621 Fannin St
Houston, TX 77030-2358
Mailing address
625 W 21St St
Houston, TX 77008-3643
Phone (601) 320-3215
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT83282 | TX | MD | Pediatric Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Children's Physician Group | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Houston, TX
- NPI 1861675506
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702339200000",
"number": "1619383551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 W 21ST ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770083643",
"telephone_number": "601-320-3215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6621 FANNIN ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770302358",
"telephone_number": "601-320-3215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOAKES",
"first_name": "JESSE",
"credential": "PA-C, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-10",
"last_updated": "2023-12-12",
"certification_date": "2023-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "TX",
"license": "DT83282",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
- Ruth E. Stitt, L.P.C.
- STJ Healthcare Services, Inc.
- STJ Medical Transportation Services
- STK Consultants
- STMS Inc., (Dba) (South Texas Adult Day Activity Center)
- Marc N Stock, DPM
- Kimberly L Stocker, M.A., CCC-SLP
- Joseph Lawrence Stockhausen, MD
- George Franklyn Stockman IV, NNP
- John Douglas Stockman, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.