Individual provider Active NPI

Jasmine Vongphachanh, FNP-C

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1891644290
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1019395 Issued in TX
Practice address
800 8TH Ave Ste 506
Fort Worth, TX 76104-2604
Phone
(682) 708-0982
NPI assigned
Jan 27, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1019395 TX Primary
Registered Nurse 163W00000X 1019395 TX

Addresses

Primary practice location

800 8TH Ave Ste 506
Fort Worth, TX 76104-2604

Mailing address

241 Herbert Park Dr
Haslet, TX 76052-2252
Phone (682) 340-8501

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

LicenseStateTypeSpecialty
1019395TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1769472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1891644290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 HERBERT PARK DR",
            "city": "HASLET",
            "state": "TX",
            "postal_code": "760522252",
            "telephone_number": "682-340-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 8TH AVE STE 506",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042604",
            "telephone_number": "682-708-0982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONGPHACHANH",
        "first_name": "JASMINE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1019395",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1019395",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.