Individual provider Active NPI

Sheila Ann Jensen, NP

  • Family Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1346574407
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28121126A Issued in IN
Practice address
25 W Division St
Evansville, IN 47710-1374
Phone
(812) 436-0205
Fax
(812) 436-0207
NPI assigned
Sep 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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 28121126A IN Primary

Addresses

Primary practice location

25 W Division St
Evansville, IN 47710-1374

Mailing address

315 Mulberry St
Evansville, IN 47713-1252
Phone (812) 421-7489

Other identifiers 1

IdentifierTypeStateIssuer
200964740MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sjensen58305@direct.deaconess.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20091114000003 IN Practitioner - Nurse Practitioner 1052459872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Echo Community Health Care IncGroup PAC ID 4981515145, 18 clinicians

Practice addresses (Care Compare)

25 W Division St
Evansville, IN 47710-1374
Phone (812) 436-0205

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28121126AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Echo Community Health Care, Inc. CurrentSince Nov 15, 2011 Accepting new patients
Echo Community Health Care, Inc CurrentSince Nov 15, 2011 Accepting new patients
Med 1St of Evansville, PC Past Accepting new patients
Echo Community Health Care, Inc. Past Accepting new patients
Med 1St of Owensboro Past Accepting new patients

Locations

401 John St
Evansville, IN 47713
Phone (812) 436-0224

315 Mulberry St
Evansville, IN 47713
Phone (812) 421-7489

25 W Division St
Evansville, IN 47710
Phone (812) 436-0205

501 John St
Ste 12
Evansville, IN 47713
Phone (812) 421-7489

Organizations & group practices 5

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 2

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": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1346574407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MULBERRY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131252",
            "telephone_number": "812-421-7489",
            "fax_number": "812-421-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W DIVISION ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101374",
            "telephone_number": "812-436-0205",
            "fax_number": "812-436-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "SHEILA",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-22",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28121126A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200964740",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjensen58305@direct.deaconess.com",
            "affiliation": "N",
            "endpointDescription": "ECHO Community Healthcare, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "25 W Division St",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477101374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.