Individual provider Active NPI

Jenna E Purdell, APRN

  • Family Nurse Practitioner
  • Saint Albans, VT
National Provider Identifier
1184902967
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
101.0080154 Issued in VT
Practice address
596 Sheldon Rd
Saint Albans, VT 05478-8011
Phone
(802) 524-6534
NPI assigned
Jul 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 101.0080154 VT Primary
Family Nurse Practitioner 363LF0000X 004988 CT

Addresses

Primary practice location

596 Sheldon Rd
Saint Albans, VT 05478-8011

Mailing address

PO Box 42738
Towson, MD 21284-2738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, CT2 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
I20110909002535 VT Practitioner - Nurse Practitioner 4486824059 Reassigns benefits to 3 organizations
I20121217000242 CT Practitioner - Nurse Practitioner 4486824059

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4988CTMDPeriodontist
004988CTMDSpeech-Language Pathologist
101.0080154VTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Center, Inc. Current Accepting new patients
Northwestern Medical Center, Inc CurrentSince Jan 12, 2015 Accepting new patients
Northwestern Medical Center Inc CurrentSince Apr 9, 2018 Accepting new patients
Alignmed Partners, PC CurrentSince Mar 14, 2018 Accepting new patients
Northwestern Medical Center, Inc. CurrentSince Jan 12, 2015 Accepting new patients
The Richford Health Center Inc Past Accepting new patients

Locations

1 Emerson Dr
Windsor, CT 06095
Phone (860) 688-6443

927 Ethan Allen Hwy
Unit 2
Milton, VT 05468
Phone (802) 524-8911

9 Haywood Ave
Rutland, VT 05701
Phone (802) 747-6433

3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

596 Sheldon Rd
Saint Albans, VT 05478
Phone (802) 524-6534

260 Crest Rd
Ste 101
Saint Albans, VT 05478
Phone (802) 524-1223

133 Fairfield St
Ste 101
Saint Albans, VT 05478
Phone (802) 524-1232

Organizations & group practices 6

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": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1184902967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42738",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212842738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 SHELDON RD",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054788011",
            "telephone_number": "802-524-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURDELL",
        "first_name": "JENNA",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-28",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101.0080154",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "004988",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, VT

Sources for this page

Verify at the official NPI Registry.