Jacqueline Deffenbaugh, APN, WHNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

277000799 Issued in IL

Practice address

2304 Stern Dr
Bloomington, IL 61704-4487

Phone

(309) 663-0411

Fax

(309) 662-2018

NPI assigned

Aug 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jackie Deffenbaugh Professional name

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Womens Healthcare SCGroup PAC ID 9133379340, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
• St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
• Carle Bromenn Medical Center Hospital, Normal, IL, CCN 140127

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Advanced Womens Healthcare SC

  • Obstetrics & Gynecology Physician
  • Bloomington, IL
  • NPI 1376890426
  Medicare reassignment Care Compare group
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

• Carle Bromenn Medical Center

  • General Acute Care Hospital
  • Normal, IL
  • NPI 1962424036
  Care Compare affiliation
• Central Dupage Hospital Association

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation
• St Joseph Medical Center

  • General Acute Care Hospital
  • Bloomington, IL
  • NPI 1619916806
  Care Compare affiliation

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1174535306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 STERN DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044487",
            "telephone_number": "309-663-0411",
            "fax_number": "309-662-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 STERN DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044487",
            "telephone_number": "309-663-0411",
            "fax_number": "309-662-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFFENBAUGH",
        "first_name": "JACQUELINE",
        "credential": "APN, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "277000799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "216064",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "DEFFENBAUGH",
            "credential": "APN, WHNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Dawn Zywiec Professional Counseling, LLC
• Michael Rene De Leon, MA
• Gretchen Dean, PT
• James Stephen Decremer, LCPC
• Ibinabo Dede, MD
• Ronald Aurthur Degon, RSA, SA-C, CSA
• Jenna Delaney, COTA
• Mary K Dellorto, PSY.D.
• Lillian Delp
• Delta Sleep'S Cpap Store

• Women's Health Nurse Practitioner in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Women's Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.