Jennifer D Gutshall, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085002531 Issued in IL

Practice address

215 E 1St St Ste 215
Dixon, IL 61021-3166

Phone

(815) 285-5422

Fax

(815) 285-5426

NPI assigned

Aug 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer D Judd Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bureau County Family HealthGroup PAC ID 7416456991, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bureau County Family Health

  • Family Medicine Physician
  • Princeton, IL
  • NPI 1326877143
  Medicare reassignment Care Compare group NPD
• KSB Medical Group, Inc.

  • Family Medicine Physician
  • Dixon, IL
  • NPI 1073592119
  Medicare reassignment NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• KSB Medical Group, Inc.

  • Eyewear Supplier
  • Dixon, IL
  • NPI 1306814603
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Cardinal Medical Group, LTD.

  • Multi-Specialty Clinic/Center
  • Peoria, IL
  • NPI 1992829485
  NPD (past)
• Osf Healthcare System

  • Rural Health Clinic/Center
  • Monmouth, IL
  • NPI 1679606073
  NPD (past)
• Saint Anthony Medical Center

  • Family Medicine Physician
  • Rockford, IL
  • NPI 1891741021
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296086400000",
    "number": "1073524328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 1ST ST STE 215",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213166",
            "telephone_number": "815-285-5422",
            "fax_number": "815-285-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E 1ST ST STE 215",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213166",
            "telephone_number": "815-285-5422",
            "fax_number": "815-285-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTSHALL",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085002531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "085002531",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "JUDD",
            "middle_name": "D",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eve Guenther, RDN, LDN
• Araseli Guerrero
• Kelly Louise Gulbranson
• Brandon R. Gumbiner, DPM
• Laura Gumbiner, PHD
• Sarah Habben, PT
• James Hagler
• Christina Lyn Hall, RBT
• Nichole Hammer-Crown, MHP
• Aliesha Handel, B.A, MHP

• Medical Physician Assistant in Dixon, IL
• Providers in Dixon, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.