Jonathan Khristopher Slade, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95007621 Issued in CA

Practice address

1625 Schrader Blvd
Los Angeles, CA 90028-6213

Phone

(323) 993-7500

NPI assigned

Dec 6, 2017

Sex

Male

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

Enrolled in CA

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jonathan.slade.1@17371.direct.athenahealth.com

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.

• Apex Multispecialty Medical Group, Inc

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1023672367
  Medicare reassignment NPD
• Los Angeles LGBT Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1548298532
  Medicare reassignment NPD
• Los Angeles LGBT Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1225599178
  NPD

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1841705233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286213",
            "telephone_number": "323-993-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286213",
            "telephone_number": "323-993-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADE",
        "first_name": "JONATHAN",
        "middle_name": "KHRISTOPHER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Skyy, DPT
• Ginger C Slack
• Margaret Carolyn Slack, MD
• Terri Ann Slade-Tucker
• Candace Slade
• Jacob Slaffey, PTA
• Jordan Ashanti Ruvenest Slaffey
• Stephanie Truong Slagel, OD
• Martha Louise Slagerman, PH.D., PSY.D.
• Deann Slaise, MSW, PPS

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; 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.