Active NPI
Jennifer Thomason, NP-C
- Family Nurse Practitioner
- Valparaiso, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71013308A
- Practice address
- 649 N 200 E
Valparaiso, IN 46383-9711 - Phone
- (219) 728-8223
- NPI assigned
- Dec 7, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041401225 | IL | |
| Family Nurse Practitioner | 363LF0000X | 209024505 | IL | |
| Family Nurse Practitioner | 363LF0000X | 71013308A | IN | Primary |
Addresses
Primary practice location
649 N 200 E
Valparaiso, IN 46383-9711
Mailing address
649 N 200 E
Valparaiso, IN 46383-9711
Phone (219) 728-8223
Other practice location 1
12251 S 80th Ave
Palos Heights, IL 60463-1290
Phone (708) 923-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041401225 | Other | IL | RPN LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1320 W State Rd
Suite 2
La Porte, IN 46350-4666
Phone (219) 727-6431
4152 W State Rd
Suite 56
Hanover, IN 47243-9070
Phone (901) 351-1791
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041401225 | IL | MD | Registered Nurse |
| 209024505 | IL | MD | Family Nurse Practitioner |
| 71013308A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Medical Clinic PLLC | Current | Accepting new patients | |
| FC Indiana, LLC | Current | Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current | Accepting new patients | |
| Midwest Express Care 2, Inc | Current | Accepting new patients | |
| FC Indiana, LLC | Current | Accepting new patients | |
| Midwest Express Care 2, Inc | Current | Accepting new patients |
Locations
40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312
2418 16th St
Bedford, IN 47421
Phone (812) 278-3154
4152 W State Road 56
Hanover, IN 47243
Phone (812) 762-4510
Organizations & group practices 6
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.
-
- Family Medicine Physician
- Hanover, IN
- NPI 1649770769
-
- Nurse Practitioner
- Bedford, IN
- NPI 1225579063
-
- Urgent Care Clinic/Center
- Willowbrook, IL
- NPI 1548692890
-
- Rural Health Clinic/Center
- Bedford, IN
- NPI 1841911591
-
- Rural Health Clinic/Center
- Chapel Hill, TN
- NPI 1316602774
-
- Urgent Care Clinic/Center
- Chicago, IL
- NPI 1659952554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733270400000",
"number": "1255099263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "649 N 200 E",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463839711",
"telephone_number": "219-728-8223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "649 N 200 E",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463839711",
"telephone_number": "219-728-8223"
}
],
"practiceLocations": [
{
"address_1": "12251 S 80th Ave",
"address_purpose": "LOCATION",
"city": "Palos Heights",
"state": "IL",
"postal_code": "604631290",
"country_code": "US",
"telephone_number": "708-923-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMASON",
"first_name": "JENNIFER",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-07",
"last_updated": "2024-12-04",
"certification_date": "2024-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041401225",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209024505",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71013308A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RPN LICENSE",
"identifier": "041401225",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Valparaiso, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.