Individual provider Active NPI

Jessica Lynn Hart, APRN-CNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Austin, TX
National Provider Identifier
1982211124
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1014396 Issued in TX
Practice address
1407 W Stassney LN
Austin, TX 78745-2947
Phone
(512) 440-4800
NPI assigned
Sep 30, 2020
Last updated
Sep 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1014396 TX Primary

Addresses

Primary practice location

1407 W Stassney LN
Austin, TX 78745-2947

Mailing address

8003 S Ih 35 Apt 3438
Austin, TX 78744-0097
Phone (703) 463-7819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210204001043 TX Practitioner - Nurse Practitioner 9830503796 Reassigns benefits to 1 organization
I20240614003504 WA Practitioner - Nurse Practitioner 9830503796 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1014396TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Connectionswa, LLC CurrentSince Aug 30, 2024 Accepting new patients
Connectionswa, LLC CurrentSince Aug 30, 2024 Accepting new patients
Alliance for South Sound Health CurrentSince May 6, 2024 Accepting new patients

Locations

1205 S 7th Ave
Ste 105
Phoenix, AZ 85007
Phone (602) 416-7647

11410 NE 122nd Way
Ste S250
Kirkland, WA 98034
Phone (425) 650-4005

3402 S 19th St
Tacoma, WA 98405
Phone (253) 301-5400

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1982211124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8003 S IH 35 APT 3438",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787440097",
            "telephone_number": "703-463-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 W STASSNEY LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787452947",
            "telephone_number": "512-440-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "APRN-CNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1014396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.