NPIMap

Organization Active NPI

Still Waters Clinic,PLLC

  • Primary Care Nurse Practitioner
  • Jenkintown, PA
National Provider Identifier
1255129367
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
STILL WATERS CLINIC,PLLC
Practice address
261 Old York Rd Ste 611
Jenkintown, PA 19046-3718
Phone
(267) 886-2634
NPI assigned
Apr 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Authorized official

Name
Jennifer Clerisson, CRNPNPI 1730624651
Title
Manager
Phone
(267) 886-2634

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

261 Old York Rd Ste 611
Jenkintown, PA 19046-3718

Mailing address

261 Old York Rd Ste 611
Jenkintown, PA 19046-3718
Phone (267) 886-2634

National Provider Directory

National Provider Directory

Locations

261 Old York Rd
Ste 611
Jenkintown, PA 19046
Phone (267) 886-2634

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1255129367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 OLD YORK RD STE 611",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463718",
            "telephone_number": "267-886-2634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 OLD YORK RD STE 611",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463718",
            "telephone_number": "267-886-2634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILL WATERS CLINIC,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "CLERISSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "267-886-2634",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenkintown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.