Individual provider Active NPI

Jadell Hovander, APRN

  • Nurse Practitioner
  • Riverton, WY
National Provider Identifier
1184381287
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
48933 Issued in WY
Practice address
716 College View Dr Ste a
Riverton, WY 82501-2282
Phone
(307) 840-0717
NPI assigned
Nov 23, 2021
Last updated
Nov 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 48933 WY Primary

Addresses

Primary practice location

716 College View Dr Ste a
Riverton, WY 82501-2282

Mailing address

PO Box 6066
Riverton, WY 82501-0399
Phone (307) 840-0717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Dec 17, 2021 through Dec 17, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
48933WYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Haven Direct Health Systems LLC CurrentSince Nov 28, 2021 Accepting new patients

Locations

716 College View Dr
Ste A
Riverton, WY 82501
Phone (307) 840-0717

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1184381287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6066",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825010399",
            "telephone_number": "307-840-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 COLLEGE VIEW DR STE A",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825012282",
            "telephone_number": "307-840-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOVANDER",
        "first_name": "JADELL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WY",
            "license": "48933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, WY

Sources for this page

Verify at the official NPI Registry.