Individual provider Active NPI

Jasmine Mariah James, DNP, APRN, FNP-BC

  • Nurse Practitioner
  • Ellington, CT
National Provider Identifier
1619685252
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
14635 Issued in CT
Practice address
105 West Rd
Ellington, CT 06029-5700
Phone
(860) 454-0678
NPI assigned
Nov 14, 2022
Last updated
Jun 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 14635 CT Primary
Registered Nurse 163W00000X 181626 CT

Addresses

Primary practice location

105 West Rd
Ellington, CT 06029-5700

Mailing address

20 Kent CT
Middletown, CT 06457-4524
Phone (860) 853-8173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20260123003053 CT Practitioner - Nurse Practitioner 5092292706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Medical Center LLCGroup PAC ID 0840570628, 52 clinicians

Practice addresses (Care Compare)

136 Berlin Rd
Cromwell, CT 06416-2627
Phone (860) 378-8585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
14635CTMDPeriodontist
181626CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Medical Center LLC Single Specialty CurrentSince Nov 11, 2025 Accepting new patients

Locations

136 Berlin Rd
Cromwell, CT 06416
Phone (860) 378-8585

105 West Rd
Ellington, CT 06029
Phone (860) 454-0678

45 S Main St
Unionville, CT 06085
Phone (860) 454-0678

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.

NPI Registry JSON

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1619685252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 KENT CT",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574524",
            "telephone_number": "860-853-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WEST RD",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060295700",
            "telephone_number": "860-454-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "JASMINE",
        "middle_name": "MARIAH",
        "credential": "DNP, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "14635",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "181626",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellington, CT

Sources for this page

Verify at the official NPI Registry.