Active NPI
Jennifer Leigh Pudenz, FNP-BC
- Family Nurse Practitioner
- Fort Dodge, IA
National Provider Identifier
1295081263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A-105220
- Practice address
- 802 Kenyon Rd
Fort Dodge, IA 50501-5740 - Phone
- (515) 574-6450
- NPI assigned
- Jul 27, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A-105220 | IA | Primary |
Addresses
Primary practice location
802 Kenyon Rd
Fort Dodge, IA 50501-5740
Mailing address
720 Park Ave
PO Box 25
Callender, IA 50523-4022
Phone (515) 351-9651
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121103000004 | IA | Practitioner - Nurse Practitioner | 3678724499 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
126 N 10TH St
Fort Dodge, IA 50501-3915
Phone (515) 576-6500
24 S Main St
Dayton, IA 50530-7698
Phone (515) 547-2974
Hospital & facility affiliations
- Trinity Regional Medical Center
- Greene County Medical Center
- Van Diest Medical Center
- Mary Greeley Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-105220 | IA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Center of Fort Dodge Inc. | Current | Accepting new patients |
Locations
24 S Main St
Dayton, IA 50530
Phone (515) 547-2974
126 N 10th St
Fort Dodge, IA 50501
Phone (515) 576-6500
Interoperability endpoints
- jpudenz637889@direct.ochin.org
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Fort Dodge, IA
- NPI 1225083728
IA
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": "1343347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343347200000",
"number": "1295081263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 PARK AVE",
"address_2": "PO BOX 25",
"city": "CALLENDER",
"state": "IA",
"postal_code": "505234022",
"telephone_number": "515-351-9651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 KENYON RD",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "505015740",
"telephone_number": "515-574-6450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUDENZ",
"first_name": "JENNIFER",
"middle_name": "LEIGH",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-27",
"last_updated": "2012-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IA",
"license": "A-105220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Dodge, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; 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.