Active NPI
Jaelynda Prothero
- Licensed Vocational Nurse
- Atascosa, TX
National Provider Identifier
1881295053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 1010784
- Practice address
- 13787 Macdona Lacoste Rd Lot 20
Atascosa, TX 78002-3532 - Phone
- (210) 502-4681
- NPI assigned
- Nov 4, 2020
- Sex
- Female
- Sole proprietor
- No
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 Vocational Nurse | 164X00000X | 1010784 | TX | Primary |
Addresses
Primary practice location
13787 Macdona Lacoste Rd Lot 20
Atascosa, TX 78002-3532
Mailing address
13787 Macdona Lacoste Rd Lot 20
Atascosa, TX 78002-3532
Phone (210) 502-4681
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 |
|---|---|---|---|
| 1010784 | TX | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1881295053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13787 MACDONA LACOSTE RD LOT 20",
"city": "ATASCOSA",
"state": "TX",
"postal_code": "780023532",
"telephone_number": "210-502-4681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13787 MACDONA LACOSTE RD LOT 20",
"city": "ATASCOSA",
"state": "TX",
"postal_code": "780023532",
"telephone_number": "210-502-4681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROTHERO",
"first_name": "JAELYNDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-04",
"last_updated": "2020-11-04",
"certification_date": "2020-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "TX",
"license": "1010784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atascosa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.