Individual provider Active NPI

Jill M Rockwell, ARNP

  • Nurse Practitioner
  • Lebanon, NH
National Provider Identifier
1205870664
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
032118-23 Issued in NH
Practice address
1 Medical Dr
Lebanon, NH 03756-1000
Phone
(603) 653-9883
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 032118-23 NH Primary

Addresses

Primary practice location

1 Medical Dr
Lebanon, NH 03756-1000

Mailing address

One Medical Center Drive
Pediatric Surgery
Lebanon, NH 03756-0001
Phone (603) 653-9883

Other identifiers 2

IdentifierTypeStateIssuer
1008165MedicaidVT
30341565MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20050629000560 NH Practitioner - Nurse Practitioner 0749226876 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032118-23NHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jun 5, 2017 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 5, 2017 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 5, 2017 Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

100 Hitchcock Way
Manchester, NH 03104
Phone (603) 629-1870

607 Chestnut St
Manchester, NH 03104

2300 Southwood Dr
Nashua, NH 03063
Phone (603) 577-4170

Interoperability endpoints

  • Direct secure messaging: jrockwell63388@direct.dartmouth-hitchcock.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205870664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER DRIVE",
            "address_2": "PEDIATRIC SURGERY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-653-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-653-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKWELL",
        "first_name": "JILL",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "032118-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008165",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30341565",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.