Individual provider Active NPI

Janice Ivie, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Vacaville, CA
National Provider Identifier
1184058737
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95001148 Issued in CA
Practice address
941 Merchant St Ste a
Vacaville, CA 95688-5315
Phone
(707) 628-4140
NPI assigned
Aug 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 493762 CA
Psychiatric/Mental Health Registered Nurse 163WP0808X NPF95001148 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95001148 CA Primary

Addresses

Primary practice location

941 Merchant St Ste a
Vacaville, CA 95688-5315

Mailing address

PO Box 6601
Vacaville, CA 95696-6601
Phone (707) 249-6898

Other practice location 1

275 Beck Ave
Fairfield, CA 94533-6804
Phone (707) 784-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150526002385 CA Practitioner - Nurse Practitioner 8628398088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

941 Merchant St
Suite a
Vacaville, CA 95688-5315
Phone (707) 249-6898

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
493762CAMDChild & Adolescent Psychiatric/Mental Health Registered Nurse
NPF95001148CAMDPsychiatric/Mental Health Registered Nurse
95001148CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
JJM Integrative Health Advanced Nursing Inc Psychiatric/Mental Health CurrentSince Feb 22, 2025 Accepting new patients

Locations

941 Merchant St
#A
Vacaville, CA 95688
Phone (707) 249-6898

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.

NPI Registry JSON

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1184058737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6601",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956966601",
            "telephone_number": "707-249-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 MERCHANT ST STE A",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956885315",
            "telephone_number": "707-628-4140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Beck Ave",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945336804",
            "country_code": "US",
            "telephone_number": "707-784-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVIE",
        "first_name": "JANICE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-29",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CA",
            "license": "493762",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NPF95001148",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95001148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

Verify at the official NPI Registry.