Individual provider Active NPI

Jamie Michelle Pranaitis

  • Registered Nurse
  • Glen Carbon, IL
National Provider Identifier
1043976905
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041467200 Issued in IL
Practice address
27 Auerbach PL
Glen Carbon, IL 62034-1596
Phone
(618) 205-2135
NPI assigned
Nov 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041467200 IL Primary

Addresses

Primary practice location

27 Auerbach PL
Glen Carbon, IL 62034-1596

Mailing address

27 Auerbach PL
Glen Carbon, IL 62034-1596
Phone (618) 205-2135

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jamie.Pranaitis@lssliving.org Direct

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
041467200ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1043976905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 AUERBACH PL",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341596",
            "telephone_number": "618-205-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 AUERBACH PL",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341596",
            "telephone_number": "618-205-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRANAITIS",
        "first_name": "JAMIE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041467200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jamie.Pranaitis@lssliving.org",
            "affiliation": "N",
            "endpointDescription": "Jamie.Pranaitis@lssliving.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "27 Auerbach Pl",
            "city": "Glen Carbon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620341596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glen Carbon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.