Active NPI
Josephine Gibson Jeter
- Licensed Practical Nurse
- Laveen, AZ
National Provider Identifier
1790484145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LP031966
- Practice address
- 8225 S 59TH Ave
Laveen, AZ 85339-2886 - Phone
- (602) 764-9016
- NPI assigned
- Feb 24, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP031966 | AZ | Primary |
Addresses
Primary practice location
8225 S 59TH Ave
Laveen, AZ 85339-2886
Mailing address
999 E Baseline Rd Apt 3105
Tempe, AZ 85283-1307
Phone (520) 788-0263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP031966 | AZ | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677196800000",
"number": "1790484145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "999 E BASELINE RD APT 3105",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852831307",
"telephone_number": "520-788-0263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8225 S 59TH AVE",
"city": "LAVEEN",
"state": "AZ",
"postal_code": "853392886",
"telephone_number": "602-764-9016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JETER",
"first_name": "JOSEPHINE",
"middle_name": "GIBSON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-24",
"last_updated": "2023-02-24",
"certification_date": "2023-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "AZ",
"license": "LP031966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Laveen, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.