NPIMap

Organization Active NPI

Jet Healthcare LLC

  • Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1265052401
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
JET HEALTHCARE LLC
Practice address
5979 Nebeshone LN
Rockford, IL 61103-8926
Phone
(815) 977-4580
NPI assigned
Apr 17, 2020
Last updated
Jul 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Darcy Milder
Title
Vice President of Operations
Phone
(515) 313-1327

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

5979 Nebeshone LN
Rockford, IL 61103-8926

Mailing address

5979 Nebeshone Lane
Rockford, IL 61103-8926
Phone (815) 977-4580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200424002398 IL Part B Supplier - Clinic/Group Practice 1456781889 Receives reassigned benefits from 30 practitioners

National Provider Directory

National Provider Directory

Locations

1190 Old McHenry Rd
Long Grove, IL 60047
Phone (224) 576-2183

6617 Broadcast Pkwy
Loves Park, IL 61111
Phone (815) 633-5880

508 Roosevelt Rd
Machesney Park, IL 61115
Phone (815) 242-2852

2203 Flagg Rd
Rochelle, IL 61068
Phone (815) 562-9800

7130 Crimson Ridge Dr
Ste 100
Rockford, IL 61107
Phone (815) 398-7792

8104 Sayer Rd
Rockford, IL 61108
Phone (815) 332-1919

500 E McNair Rd
Winnebago, IL 61088
Phone (262) 696-8252

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1265052401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5979 NEBESHONE LANE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611038926",
            "telephone_number": "815-977-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 NEBESHONE LN",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611038926",
            "telephone_number": "815-977-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JET HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-17",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "MILDER",
        "authorized_official_first_name": "DARCY",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "515-313-1327"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.