Active NPI
Michele Lee Jensen, RN
- Registered Nurse
- Waterloo, IA
National Provider Identifier
1083337398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 112604
- Practice address
- 604 Lafayette St
Waterloo, IA 50703-4708 - Phone
- (833) 370-0719
- Fax
- (515) 220-2272
- NPI assigned
- Sep 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 112604 | IA | Primary |
Addresses
Primary practice location
604 Lafayette St
Waterloo, IA 50703-4708
Mailing address
604 Lafayette St
Waterloo, IA 50703-4708
Phone (833) 370-0719
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | 5152202272 | 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112604 | IA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663718400000",
"number": "1083337398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 LAFAYETTE ST",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507034708",
"telephone_number": "833-370-0719",
"fax_number": "515-220-2272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 LAFAYETTE ST",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507034708",
"telephone_number": "833-370-0719",
"fax_number": "515-220-2272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "MICHELE",
"middle_name": "LEE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-21",
"last_updated": "2022-09-21",
"certification_date": "2022-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IA",
"license": "112604",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "5152202272",
"affiliation": "N",
"endpointDescription": "Fax",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "604 Lafayette St",
"city": "Waterloo",
"state": "IA",
"country_code": "US",
"postal_code": "507034708",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.