Michael T Jobe, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

6049 Issued in AZ

Practice address

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600

Phone

(702) 653-3040

NPI assigned

Aug 26, 2011

Last updated

Aug 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1669752317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOBE",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-26",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "6049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kennedi James
• Christopher Ikaikamauloa Jenkins
• Jacqueline Jensen, MD
• Scott T Jensen, M.D.
• Cheryl Jobe, DNP, FNP, AGACNP
• Jared Joffer, DO
• Aaron A Johnson, DO
• Eric S Johnson, RPH
• Jacey Cole Johnson, LCSW
• Jennifer Lynn Johnson, DO

• Surgical Physician Assistant in Nellis AFB, NV
• Providers in Nellis AFB, NV by specialty
• Surgical Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.