Individual provider Active NPI

Jessy Sabu Philip, ANP

  • Gerontology Nurse Practitioner
  • Houston, TX
National Provider Identifier
1912198805
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP116034 Issued in TX
Practice address
8307 Knight Rd
Houston, TX 77054
Phone
(713) 796-9955
NPI assigned
Aug 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 685688 TX
Gerontology Nurse Practitioner 363LG0600X AP116034 TX Primary

Addresses

Primary practice location

8307 Knight Rd
Houston, TX 77054

Mailing address

PO Box 3345
Houston, TX 77253-3345
Phone (713) 796-9955

Other practice location 1

3601 N MacGregor Way
Quentin Mease - Geriatrics
Houston, TX 77004-8004
Phone (713) 873-4895

Other practice location 2

3601 N MacGregor Way
Quentin Mease - Geriatrics
Houston, TX 77004-8004
Phone (713) 873-4895

Other identifiers 1

IdentifierTypeStateIssuer
187942101MedicaidTX

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
685688TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1912198805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3345",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772533345",
            "telephone_number": "713-796-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8307 KNIGHT RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77054",
            "telephone_number": "713-796-9955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 N MacGregor Way",
            "address_2": "Quentin Mease - Geriatrics",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770048004",
            "country_code": "US",
            "telephone_number": "713-873-4895",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 N MacGregor Way",
            "address_2": "Quentin Mease - Geriatrics",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770048004",
            "country_code": "US",
            "telephone_number": "713-873-4895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "JESSY",
        "middle_name": "SABU",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "685688",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP116034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187942101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.