Jessica Klube, CCP

Primary specialty

PerfusionistTaxonomy code 242T00000X

Practice address

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Phone

(410) 718-8802

NPI assigned

Dec 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1699488361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16535 OLD FREDERICK RD",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217713345",
            "telephone_number": "410-718-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "410-718-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUBE",
        "first_name": "JESSICA",
        "credential": "CCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela S Klonoff, PHD
• Erin Kloos, M.D.
• Brandon Klor
• David Kloss, DDS
• KLS Behavioral Health LLC
• Taylor Lyn Kluesner, MA, CCC-SLP
• Barbara Regina Kluger, DPM
• Arlene Dawn Kluizenaar, PA
• Laura E Klusovsky, P.A.-C.
• Kma Surgical Assist LLC

• Perfusionist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Perfusionist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.