Individual provider Active NPI

Jill Haldeman, BSN

  • Registered Nurse
  • Mount Vernon, OH
National Provider Identifier
1326436015
Registry record updated Jan 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
405357 Issued in OH
Practice address
902 W Gambier St
Mount Vernon, OH 43050-3019
Phone
(740) 501-2472
NPI assigned
Jan 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 405357 OH Primary

Addresses

Primary practice location

902 W Gambier St
Mount Vernon, OH 43050-3019

Mailing address

902 W Gambier St
Mount Vernon, OH 43050-3019
Phone (740) 501-2472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
405357OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1420243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420243200000",
    "number": "1326436015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W GAMBIER ST",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503019",
            "telephone_number": "740-501-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W GAMBIER ST",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503019",
            "telephone_number": "740-501-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALDEMAN",
        "first_name": "JILL",
        "credential": "BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-03",
        "last_updated": "2015-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "405357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2015; 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.