NPIMap

Organization Active NPI

Jam Healthcare Inc

Doing business as Jabez Medical Group

  • Family Medicine Physician
  • Reno, NV
National Provider Identifier
1942894993
Registry record updated Feb 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JAM HEALTHCARE INC
Doing business as
Jabez Medical Group
Practice address
3680 Grant Dr Ste F
Reno, NV 89509-5350
Phone
(702) 302-6587
NPI assigned
Feb 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2021

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

Authorized official

Name
Julian Theodore Bernardo
Title
Practice Manager
Phone
(702) 302-6587

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

3680 Grant Dr Ste F
Reno, NV 89509-5350

Mailing address

3680 Grant Dr Ste F
Reno, NV 89509-5350

Other names 1

  • JABEZ MEDICAL GROUP Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210722002856 NV Part B Supplier - Clinic/Group Practice 9739597543 Receives reassigned benefits from 12 practitioners
Practice locations: Las Vegas, NV; Reno, NV

National Provider Directory

National Provider Directory

Locations

3680 Grant Dr
Ste F
Reno, NV 89509
Phone (702) 302-6587

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1613865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613865600000",
    "number": "1942894993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3680 GRANT DR STE F",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895095350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 GRANT DR STE F",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895095350",
            "telephone_number": "702-302-6587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAM HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-21",
        "last_updated": "2021-02-21",
        "certification_date": "2021-02-21",
        "status": "A",
        "authorized_official_last_name": "BERNARDO",
        "authorized_official_first_name": "JULIAN",
        "authorized_official_middle_name": "THEODORE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "702-302-6587"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JABEZ MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.