Active NPI
Jacquelyn Elizabeth Mowday, NURSE PRACTITIONER
- Women's Health Nurse Practitioner
- Broomall, PA
National Provider Identifier
1144296948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- SP005873G
- Practice address
- 1991 Sproul Rd
Suite 200
Broomall, PA 19008-3512 - Phone
- (610) 325-1350
- Fax
- (610) 325-1357
- NPI assigned
- Feb 23, 2006
- 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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | SP005873G | PA | Primary |
Addresses
Primary practice location
1991 Sproul Rd
Suite 200
Broomall, PA 19008-3512
Mailing address
1991 Sproul Rd
Suite 200
Broomall, PA 19008-3512
Phone (610) 325-1350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 232359401 | Other | PW | MAIN LINE HEALTHCARE |
Other names 1
- Ms. Jacquelyn Elizabeth Kerr
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP005873G | PA | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Main Line Healthcare | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Newtown Square, PA
- NPI 1922077643
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503532800000",
"number": "1144296948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1991 SPROUL RD",
"address_2": "SUITE 200",
"city": "BROOMALL",
"state": "PA",
"postal_code": "190083512",
"telephone_number": "610-325-1350",
"fax_number": "610-325-1357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1991 SPROUL RD",
"address_2": "SUITE 200",
"city": "BROOMALL",
"state": "PA",
"postal_code": "190083512",
"telephone_number": "610-325-1350",
"fax_number": "610-325-1357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOWDAY",
"first_name": "JACQUELYN",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-23",
"last_updated": "2017-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "PA",
"license": "SP005873G",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAIN LINE HEALTHCARE",
"identifier": "232359401",
"state": "PW"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JACQUELYN",
"last_name": "KERR",
"middle_name": "ELIZABETH",
"prefix": "MS.",
"credential": "NURSE PRACTITIONER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Broomall, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.