Jasmine Desiree Sutton, APRN, AGNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

1113466 Issued in TX

Practice address

6706 San Miguel Way
Converse, TX 78109-3774

Phone

(210) 445-9636

NPI assigned

Mar 22, 2023

Sex

Female

Sole proprietor

Yes

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 OR

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

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1831892603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6706 SAN MIGUEL WAY",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781093774",
            "telephone_number": "210-445-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6706 SAN MIGUEL WAY",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781093774",
            "telephone_number": "210-445-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "JASMINE",
        "middle_name": "DESIREE",
        "name_prefix": "Ms.",
        "credential": "APRN, AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "1113466",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1113466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Stankiewicz, LVN
• Margaret Lucille Stark
• Chantelle Stoops, LCSW
• Adam Stovall
• Daphney Sully
• Rene Talbot, CRC, LPC
• Griselda Gonzales Tamez, R.PH. , PHARM. D.
• Andres Tano Robles
• Kenneth James Teninty, LMT
• Shontel Terrell

• Primary Care Nurse Practitioner in Converse, TX
• Providers in Converse, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.