Individual provider Active NPI

Jamie Kaye Weis, CPNP

  • Pediatric Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1295162592
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209020734 Issued in IL
Practice address
4655 N Elston Ave
Chicago, IL 60630-4216
Phone
(773) 685-3288
Fax
(773) 685-7748
NPI assigned
Oct 1, 2013
Last updated
Sep 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024174289 VA
Pediatric Nurse Practitioner 363LP0200X 209020734 IL Primary
Pediatric Nurse Practitioner 363LP0200X R211084 MD
Pediatric Registered Nurse 163WP0200X R211084 MD

Addresses

Primary practice location

4655 N Elston Ave
Chicago, IL 60630-4216

Mailing address

4655 N Elston Ave
Chicago, IL 60630-4216
Phone (773) 685-3288

Other practice location 1

5881 Leesburg Pike
Suite 400
Falls Church, VA 22041-2314
Phone (703) 820-2899

Other names 1

  • Jamie Kaye Ringler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20231103001265 IL Practitioner - Nurse Practitioner 5799132320 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R211084MDMDPediatric Registered Nurse
0024174289VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Sep 18, 2023 Accepting new patients
The University of Chicago Medical Center CurrentSince Sep 18, 2023 Accepting new patients
Kidz Health P.C. PastSince Sep 27, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1295162592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606304216",
            "telephone_number": "773-685-3288",
            "fax_number": "773-685-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606304216",
            "telephone_number": "773-685-3288",
            "fax_number": "773-685-7748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5881 Leesburg Pike",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220412314",
            "country_code": "US",
            "telephone_number": "703-820-2899",
            "fax_number": "703-820-2890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIS",
        "first_name": "JAMIE",
        "middle_name": "KAYE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-01",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024174289",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209020734",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R211084",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MD",
            "license": "R211084",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "RINGLER",
            "middle_name": "KAYE",
            "credential": "CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.