Jasmine Petty-Gooden

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN.186165 Issued in OH

Practice address

711 W Wenger Rd Apt 151
Englewood, OH 45322-1913

Phone

(937) 668-3289

NPI assigned

Aug 25, 2023

Last updated

Feb 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1982489399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W WENGER RD APT 151",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453221913",
            "telephone_number": "937-979-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W WENGER RD APT 151",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453221913",
            "telephone_number": "937-668-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY-GOODEN",
        "first_name": "JASMINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OH",
            "license": "LPN.186165",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.186165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Drew Perkins, PHARMD
• Terronica Perkins
• Marcellena Perry
• Tiffanie Perry, CDCA
• Angel Person
• Tyler Pfahl
• Jodi Phares
• Richard Phillips, LMT
• Gary William Pierce, D.D.S.
• Robert James Piergies

• Licensed Practical Nurse in Englewood, OH
• Providers in Englewood, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.