Individual provider Active NPI

Taleasha Jerde

  • Sonography Radiologic Technologist
  • Maplewood, MN
National Provider Identifier
1912329228
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sonography Radiologic TechnologistTaxonomy code 2471S1302X
License
161449 Issued in TX
Practice address
1236 Farrell St N
Maplewood, MN 55119-3175
Phone
(612) 454-8611
NPI assigned
Jan 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sonography Radiologic Technologist 2471S1302X 161449 TX Primary

Addresses

Primary practice location

1236 Farrell St N
Maplewood, MN 55119-3175

Mailing address

1236 Farrell St N
Maplewood, MN 55119-3175

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
161449TXMDSonography Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1912329228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 FARRELL ST N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551193175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 FARRELL ST N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551193175",
            "telephone_number": "612-454-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERDE",
        "first_name": "TALEASHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-07",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "TX",
            "license": "161449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; 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.