Active NPI
Jasmine Monae Tubbs, FNP
- Family Nurse Practitioner
- Fort Wayne, IN
National Provider Identifier
1891329819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F02201067
- Practice address
- 875 Petal Way
Fort Wayne, IN 46816-8900 - Phone
- (260) 249-3516
- NPI assigned
- Feb 28, 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F02201067 | IN | Primary |
Addresses
Primary practice location
875 Petal Way
Fort Wayne, IN 46816-8900
Mailing address
875 Petal Way
Fort Wayne, IN 46816-8900
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 |
|---|---|---|---|
| F02201067 | IN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582848000000",
"number": "1891329819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "875 PETAL WAY",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468168900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 PETAL WAY",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468168900",
"telephone_number": "260-249-3516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUBBS",
"first_name": "JASMINE",
"middle_name": "MONAE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-28",
"last_updated": "2020-02-28",
"certification_date": "2020-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "F02201067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.