Individual provider Active NPI

Jaclyn Michelle Cherry, RN, ACNP

  • Acute Care Nurse Practitioner
  • Wilmington, DE
National Provider Identifier
1124290937
Registry record updated Oct 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP009771 Issued in PA
Practice address
100 Clayton Street, Suite 500
Pulmonary Associates
Wilmington, DE 19803
Phone
(302) 656-2296
NPI assigned
Apr 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN557986 PA
Registered Nurse 163W00000X L1-0030704 DE
Nurse Practitioner 363L00000X LZ-0000113 DE
Acute Care Nurse Practitioner 363LA2100X SP009771 PA Primary

Addresses

Primary practice location

100 Clayton Street, Suite 500
Pulmonary Associates
Wilmington, DE 19803

Mailing address

203 Bromley Dr
Wilmington, DE 19808-1375
Phone (302) 256-0653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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

Enrollment IDStateProvider typePAC IDDetails
I20091006000283 DE Practitioner - Nurse Practitioner 8426194457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

4745 Ogletown Stanton Rd
Newark, DE 19713-2074
Phone (302) 623-7600

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1-0030704DEMDRegistered Nurse
RN557986PAMDRegistered Nurse
LZ-0000113DEMDNurse Practitioner
SP009771PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc CurrentSince Dec 31, 2011 Accepting new patients
Christiana Care Health Services Inc CurrentSince Dec 31, 2011 Accepting new patients
Pulmonary Associates P.a. Past Accepting new patients
Christiana Care Health Services, Inc Nurse Practitioner Past Accepting new patients

Locations

4745 Stanton Ogletwn Rd
Newark, DE 19713
Phone (302) 623-7600

4735 Ogletown Stanton Rd
Ste 2224
Newark, DE 19713
Phone (302) 266-0355

4745 Stanton Ogletwn Rd
Ste 220
Newark, DE 19713
Phone (302) 368-5515

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255910400000",
    "number": "1124290937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 BROMLEY DR",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081375",
            "telephone_number": "302-256-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CLAYTON STREET, SUITE 500",
            "address_2": "PULMONARY ASSOCIATES",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19803",
            "telephone_number": "302-656-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERRY",
        "first_name": "JACLYN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "RN, ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2009-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN557986",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0030704",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LZ-0000113",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP009771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.