Individual provider Active NPI

Jordan Marie Hendricks, FNP-BC

  • Family Nurse Practitioner
  • Roscoe, IL
National Provider Identifier
1225785991
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
31261 Issued in TN
Practice address
4282 E Rockton Rd
Roscoe, IL 61073-7420
Phone
(779) 696-9000
NPI assigned
Mar 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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 31261 TN Primary

Addresses

Primary practice location

4282 E Rockton Rd
Roscoe, IL 61073-7420

Mailing address

1900 Belmont Blvd
Nashville, TN 37212-3757
Phone (615) 460-5506

Other practice location 1

1900 Belmont Blvd
Nashville, TN 37212-3757
Phone (615) 460-5506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20230112002490 IL Practitioner - Nurse Practitioner 9830569623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

4282 E Rockton Rd
Sa Stateline Clinic
Roscoe, IL 61073-7420
Phone (779) 696-9000

6824 Newburg Rd
Sa Valley
Rockford, IL 61108-4330
Phone (779) 696-7610

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
83.2
Promoting interoperability
77
Improvement activities
40
Cost
71.7

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31261TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital CurrentSince Sep 16, 2022 Accepting new patients
Swedishamerican Hospital Current Accepting new patients
Swedishamerican Hospital CurrentSince Sep 16, 2022 Accepting new patients

Locations

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

4282 E Rockton Rd
Roscoe, IL 61073
Phone (779) 676-8160

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1225785991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 BELMONT BLVD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372123757",
            "telephone_number": "615-460-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4282 E ROCKTON RD",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610737420",
            "telephone_number": "779-696-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Belmont Blvd",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372123757",
            "country_code": "US",
            "telephone_number": "615-460-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "JORDAN",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "31261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roscoe, IL

Sources for this page

Verify at the official NPI Registry.