Individual provider Active NPI

Jade Arden Cobern

  • Student in an Organized Health Care Education/Training Program
  • Baltimore, MD
National Provider Identifier
1649775776
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1800 Orleans St
Baltimore, MD 21287-0010
Phone
(410) 955-6070
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1800 Orleans St
Baltimore, MD 21287-0010

Mailing address

108 Young St
Water Valley, MS 38965-2912
Phone (662) 419-9446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230724001847 TX Practitioner - Pediatric Medicine 1153679592 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lechee Health Facility CurrentSince Jul 10, 2023 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Jul 10, 2023 Accepting new patients
Tuba City Regional Health Care Corporation Current Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1649775776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 YOUNG ST",
            "city": "WATER VALLEY",
            "state": "MS",
            "postal_code": "389652912",
            "telephone_number": "662-419-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ORLEANS ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870010",
            "telephone_number": "410-955-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBERN",
        "first_name": "JADE",
        "middle_name": "ARDEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.