Individual provider Active NPI

Jennifer Jeanty, APN-C, DNP

  • Nurse Practitioner
  • Denville, NJ
National Provider Identifier
1235680430
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00671200 Issued in NJ
Practice address
280 W Main St FL 2
Denville, NJ 07834
Phone
(973) 957-0871
NPI assigned
Oct 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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 26NJ00671200 NJ Primary

Addresses

Primary practice location

280 W Main St FL 2
Denville, NJ 07834

Mailing address

280 W Main St
Denville, NJ 07834-1233
Phone (973) 957-0871

Other practice location 1

502 Main St
Boonton, NJ 07005-1716
Phone (973) 978-3175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20161201000166 NJ Practitioner - Nurse Practitioner 7113207549

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00671200NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Davis Chiropractic Center LLC CurrentSince Dec 19, 2017 Accepting new patients

Locations

316 Orange Rd
Montclair, NJ 07042
Phone (973) 783-3606

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1477094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1235680430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 W MAIN ST",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078341233",
            "telephone_number": "973-957-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 W MAIN ST FL 2",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "07834",
            "telephone_number": "973-957-0871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 Main St",
            "address_purpose": "LOCATION",
            "city": "Boonton",
            "state": "NJ",
            "postal_code": "070051716",
            "country_code": "US",
            "telephone_number": "973-978-3175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEANTY",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "APN-C, DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-22",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00671200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denville, NJ

Sources for this page

Verify at the official NPI Registry.