Individual provider Active NPI

Jennifer Van Meeteren, APRN-NP

  • Nurse Practitioner
  • Glenwood, IA
National Provider Identifier
1154761021
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A142336 Issued in IA
Practice address
320 Ebaugh St
Glenwood, IA 51534-1811
Phone
(712) 527-5204
Fax
(712) 527-9346
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A142336 IA Primary
Nurse Practitioner 363L00000X 111506 NE
Registered Nurse 163W00000X 68917 NE

Addresses

Primary practice location

320 Ebaugh St
Glenwood, IA 51534-1811

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other identifiers 7

IdentifierTypeStateIssuer
47068731734MedicaidNE
47068731749MedicaidNE
1154761021MedicaidIA
10026480100MedicaidNE
47068731712MedicaidNE
47068731777MedicaidNE
47068731741MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 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
I20131025001173 NE Practitioner - Nurse Practitioner 6507091691 Reassigns benefits to 2 organizations
I20151209001260 IA Practitioner - Nurse Practitioner 6507091691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

10710 Fort St
Omaha, NE 68134-1230
Phone (402) 354-7500

320 Ebaugh St
Methodist Physicians Clinic Glenwood
Glenwood, IA 51534-1811
Phone (712) 527-5204

Hospital & facility affiliations

  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68917NEMDRegistered Nurse
A142336IAMDNurse Practitioner
111506NEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Nurse Practitioner CurrentSince Oct 19, 2020 Accepting new patients
Physicians Clinic Inc Nurse Practitioner CurrentSince Dec 28, 2015 Accepting new patients

Locations

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

320 Ebaugh St
Glenwood, IA 51534
Phone (712) 527-5204

20021 Manderson St
Elkhorn, NE 68022
Phone (402) 815-6600

1240 E 23rd St
Fremont, NE 68025
Phone (402) 721-8668

680 E Fremont Medical Park Dr
Fremont, NE 68025
Phone (402) 727-1091

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

10710 Fort St
Omaha, NE 68134
Phone (402) 354-7500

208 S 26th Ave
Omaha, NE 68131
Phone (402) 354-3198

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

8303 Dodge St
Ste LL6
Omaha, NE 68114
Phone (402) 354-4104

Organizations & group practices 2

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1154761021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 EBAUGH ST",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515341811",
            "telephone_number": "712-527-5204",
            "fax_number": "712-527-9346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN MEETEREN",
        "first_name": "JENNIFER",
        "credential": "APRN-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A142336",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "111506",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "68917",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731734",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731749",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154761021",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026480100",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731712",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731777",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731741",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood, IA

Sources for this page

Verify at the official NPI Registry.