Individual provider Active NPI

Jennifer Wood

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1023550688
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
041445801 Issued in IL
Practice address
550 W Arlington PL Apt 801
Chicago, IL 60614-6429
Phone
(616) 402-7013
NPI assigned
Nov 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN1033676 DC
Registered Nurse 163W00000X 041445801 IL
Certified Registered Nurse Anesthetist 367500000X 113372 IL
Certified Registered Nurse Anesthetist 367500000X 041445801 IL Primary

Addresses

Primary practice location

550 W Arlington PL Apt 801
Chicago, IL 60614-6429

Mailing address

550 W Arlington PL Apt 801
Chicago, IL 60614-6429

Other practice location 1

1919 19th St NW
Apt 203
Washington, DC 20009-1258
Phone (616) 402-7013

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)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN1033676DCMDRegistered Nurse
041445801ILMDCertified Registered Nurse Anesthetist
113372ILMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1023550688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W ARLINGTON PL APT 801",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W ARLINGTON PL APT 801",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146429",
            "telephone_number": "616-402-7013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 19th St NW",
            "address_2": "Apt 203",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200091258",
            "country_code": "US",
            "telephone_number": "616-402-7013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1033676",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041445801",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "113372",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041445801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.