Individual provider Active NPI

Jessica Prenot, NP

  • Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1104795954
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.034881 Issued in IL
Practice address
5979 Nebeshone LN
Rockford, IL 61103-8926
Phone
(815) 977-4908
NPI assigned
Oct 31, 2025
Last updated
Jun 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.034881 IL Primary
Nurse Practitioner 363L00000X 17650-33 WI

Addresses

Primary practice location

5979 Nebeshone LN
Rockford, IL 61103-8926

Mailing address

12772 Freeport Rd
Durand, IL 61024-9736
Phone (815) 703-3740

Other practice location 1

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20251212003618 WI Practitioner - Nurse Practitioner 7911491246 Reassigns benefits to 1 organization
I20260505003437 IL Practitioner - Nurse Practitioner 7911491246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
17650-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Nov 10, 2025 Accepting new patients
Mercy Health System Corporation CurrentSince Nov 10, 2025 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

Interoperability endpoints

  • Direct secure messaging: jprenot50201@direct.mhemail.org

Organizations & group practices 3

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1761868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1104795954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12772 FREEPORT RD",
            "city": "DURAND",
            "state": "IL",
            "postal_code": "610249736",
            "telephone_number": "815-703-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 NEBESHONE LN",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611038926",
            "telephone_number": "815-977-4908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Mineral Point Ave",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535482940",
            "country_code": "US",
            "telephone_number": "608-756-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRENOT",
        "first_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-31",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.034881",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "17650-33",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.