Individual provider Active NPI

Jennifer Lyn Vance, PA

  • Family Nurse Practitioner
  • Sterling, IL
National Provider Identifier
1316183429
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
085003396 Issued in IL
Practice address
101 E Miller Rd
Sterling, IL 61081-1252
Phone
(815) 625-4790
NPI assigned
Dec 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 085003396 IL Primary

Addresses

Primary practice location

101 E Miller Rd
Sterling, IL 61081-1252

Mailing address

101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790

Other names 1

  • Jennifer Lyn Horwath Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20171107000583 MI Practitioner - Physician Assistant 1153487491

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

305 Thomas St
Allegan, MI 49010-9158

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
100
Improvement activities
40
Cost
57.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allegan Professional Health Services Inc CurrentSince Oct 26, 2017 Accepting new patients
CGH Medical Center Past Accepting new patients

Locations

551 Linn St
Allegan, MI 49010
Phone (269) 686-5800

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1316183429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252",
            "telephone_number": "815-625-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252",
            "telephone_number": "815-625-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "JENNIFER",
        "middle_name": "LYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-18",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "085003396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HORWATH",
            "middle_name": "LYN",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sterling, IL

Sources for this page

Verify at the official NPI Registry.