MR. JESSE KORTH NP-C NPI 1457870586

NPI Information

NPI: 1457870586
Provider Name: MR. JESSE KORTH, NP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
255 N WHITE RD STE 200
SAN JOSE, CA
ZIP 95127
Phone: (866) 646-3553
Get Directions

MR. Jesse Korth, NP-C is a family nurse practitioner in San Jose, CA. MR. Jesse Korth, NP-C NPI is 1457870586. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

255 N WHITE RD STE 200
SAN JOSE, CA
ZIP 95127-966
Phone: (866) 646-3553

The NPI 1457870586 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/9/2017 and was last updated on 12/30/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WC0200X	Registered Nurse	Critical Care Medicine	95028029	CALIFORNIA	No
2	163WC0200X	Registered Nurse	Critical Care Medicine	87827	WEST VIRGINIA	No
3	163WC0200X	Registered Nurse	Critical Care Medicine	238714	NORTH CAROLINA	No
4	363LF0000X	Nurse Practitioner	Family	95012974	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	95012974	OTHER	CALIFORNIA	BOARD OF NURSING NP LICENSE
2	95029028	OTHER	CALIFORNIA	BOARD OF NURSING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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