Individual provider Active NPI

Jayne Ellen Pugh, LPN

  • Long-Term Care Clinical Nurse Specialist
  • Peru, IN
National Provider Identifier
1033858949
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long-Term Care Clinical Nurse SpecialistTaxonomy code 364SL0600X
License
27053965A Issued in IN
Practice address
269 Meadowview Dr
Peru, IN 46970-8996
Phone
(765) 472-8049
NPI assigned
May 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long-Term Care Clinical Nurse Specialist 364SL0600X 27053965A IN Primary

Addresses

Primary practice location

269 Meadowview Dr
Peru, IN 46970-8996

Mailing address

269 Meadowview Dr
Peru, IN 46970-8996
Phone (765) 472-8049

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27053965AINMDLong-Term Care Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1033858949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 MEADOWVIEW DR",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469708996",
            "telephone_number": "765-472-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 MEADOWVIEW DR",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469708996",
            "telephone_number": "765-472-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "JAYNE",
        "middle_name": "ELLEN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SL0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Long-Term Care",
            "state": "IN",
            "license": "27053965A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peru, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.