Jackie Judith Natividad, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1083737 Issued in TX

Practice address

8045 N Loop Dr Ste a
El Paso, TX 79915-3227

Phone

(915) 248-1793

Fax

(915) 225-3745

NPI assigned

Jun 8, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622
  NPD (past)

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1700515368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6385 CALLE AZUL WAY",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799127524",
            "telephone_number": "915-258-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8045 N LOOP DR STE A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799153227",
            "telephone_number": "915-248-1793",
            "fax_number": "915-225-3745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5401 Montana Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799034909",
            "country_code": "US",
            "telephone_number": "915-265-1157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 S Mesa Hills Dr Ste C3",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799125765",
            "country_code": "US",
            "telephone_number": "915-295-0344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NATIVIDAD",
        "first_name": "JACKIE",
        "middle_name": "JUDITH",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2023-01-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1083737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jackie.natividad.1@13711.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Village Medical Texas",
            "address_1": "5401 Montana Ave Ste B",
            "city": "El Paso",
            "state": "TX",
            "country_code": "US",
            "postal_code": "799034909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jackie.natividad.1@13711.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Village Medical Texas",
            "address_1": "8045 N Loop Dr Ste A",
            "city": "El Paso",
            "state": "TX",
            "country_code": "US",
            "postal_code": "799153227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jackie.natividad.1@13711.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Village Medical Texas",
            "address_1": "550 S Mesa Hills Dr Ste C3",
            "city": "El Paso",
            "state": "TX",
            "country_code": "US",
            "postal_code": "799125765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• National Orthodontix Management, LLC
• National Orthodontix Management, LLC
• National Seating & Mobility, Inc.
• National Vision, Inc.
• National Vision, Inc.
• Jaime Natividad
• Lorena Natividad, N.P.
• Pedro Natividad Jr., FNP
• Toribio Tomas Natividad, MD
• Alberto Nava II, PHARM D

• Family Nurse Practitioner in El Paso, TX
• Providers in El Paso, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.