Individual provider Active NPI

Jordan Wasserburger, CRNP

  • Acute Care Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1245629344
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-126504 Issued in AL
Practice address
101 Sivley Rd SW
Huntsville, AL 35801-4421
Phone
(256) 265-3360
NPI assigned
Jan 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-126504 AL Primary

Addresses

Primary practice location

101 Sivley Rd SW
Huntsville, AL 35801-4421

Mailing address

101 Sivley Rd SW
Huntsville, AL 35801-4421
Phone (256) 265-3360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20151021001094 AL Practitioner - Nurse Practitioner 3870802416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HH Tennessee Valley Pain CenterGroup PAC ID 4587075783, 33 clinicians

Practice addresses (Care Compare)

201 Governors Dr SW
Suite 400
Huntsville, AL 35801-5183
Phone (256) 265-7246

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1-126504ALMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HH Tennessee Valley Pain Center CurrentSince Sep 15, 2024 Accepting new patients
Tennessee Valley Pain Consultants, PC Past Accepting new patients

Locations

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

201 Governors Dr SW
Ste 400
Huntsville, AL 35801
Phone (256) 265-7246

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 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": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1245629344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SIVLEY RD SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014421",
            "telephone_number": "256-265-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SIVLEY RD SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014421",
            "telephone_number": "256-265-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERBURGER",
        "first_name": "JORDAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-126504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.