Individual provider Active NPI

Jessica L Slattery, CNP

  • Nurse Practitioner
  • Auburn, IN
National Provider Identifier
1245518927
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71014774A Issued in IN
Practice address
1306 E 7TH St Ste a
Auburn, IN 46706-2537
Phone
(260) 925-1255
Fax
(260) 925-1256
NPI assigned
Jul 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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 COA.12439-NP OH
Nurse Practitioner 363L00000X 71014774A IN Primary

Addresses

Primary practice location

1306 E 7TH St Ste a
Auburn, IN 46706-2537

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other names 1

  • Jessica L Haase Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN2 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
I20111013000643 OH Practitioner - Nurse Practitioner 9537331608
I20240228002516 IN Practitioner - Nurse Practitioner 9537331608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkview Health System IncGroup PAC ID 2163336967, 1,350 clinicians

Practice addresses (Care Compare)

817 Trail Ridge Rd
Albion, IN 46701-1534
Phone (260) 373-9590

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
70
Promoting interoperability
100
Improvement activities
40
Cost
75.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71014774AINMDNurse Practitioner
COA.12439-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Nurse Practitioner CurrentSince Feb 22, 2024 Accepting new patients
Community Memorial Hospital Past Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

1306 E 7th St
Ste A
Auburn, IN 46706
Phone (219) 725-1255

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

208 Columbus St
Hicksville, OH 43526
Phone (419) 542-6692

Interoperability endpoints

  • Direct secure messaging: jslattery79239@direct.parkviewexchange.com

Organizations & group practices 2

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 5

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": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1245518927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 E 7TH ST STE A",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467062537",
            "telephone_number": "260-925-1255",
            "fax_number": "260-925-1256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATTERY",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-28",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.12439-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71014774A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HAASE",
            "middle_name": "L",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Auburn, IN

Sources for this page

Verify at the official NPI Registry.