Individual provider Active NPI

Jessica Ann Anderson, ARNP

  • Family Nurse Practitioner
  • Manchester, IA
National Provider Identifier
1184952632
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A112774 Issued in IA
Practice address
409 W Marion St
Manchester, IA 52057-2015
Phone
(319) 626-2192
NPI assigned
Nov 20, 2009
Last updated
Jan 23, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A112774 IA Primary

Addresses

Primary practice location

409 W Marion St
Manchester, IA 52057-2015

Mailing address

409 West Marion Street
Dubuque, IA 52317

Other names 1

  • Jessica Ann Berns Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20100320000023 IA Practitioner - Nurse Practitioner 6002941721 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington County HospitalGroup PAC ID 2062329931, shared by 8 NPIs, 39 clinicians

Practice addresses (Care Compare)

400 E Polk St
Washington, IA 52353-1237
Phone (319) 653-5481

400 E Polk St WCHC Specialty Clinic
Ken and Rosemary Hanson Specialty Clinic
Washington, IA 52353-1237
Phone (319) 653-5481

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A112774IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington County Hospital Current Accepting new patients
Washington County Hospital CurrentSince Sep 1, 2020 Accepting new patients
Washington County Hospital CurrentSince Sep 1, 2020 Accepting new patients
Washington County Hospital Past Accepting new patients

Locations

400 E Polk St
Washington, IA 52353
Phone (319) 653-5481

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/washin-6836dd27
  • Direct secure messaging: janderson264605@uihcdirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1184952632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 WEST MARION STREET",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "52317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W MARION ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520572015",
            "telephone_number": "319-626-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-20",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A112774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BERNS",
            "middle_name": "ANN",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, IA

Sources for this page

Verify at the official NPI Registry.