Individual provider Active NPI

Jennifer Worden, FNP-BC

  • Family Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1346616067
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704220001 Issued in MI
Practice address
505 N Jackson St
Jackson, MI 49201-1266
Phone
(517) 748-5500
NPI assigned
Aug 17, 2015
Last updated
Aug 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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 4704220001 MI Primary

Addresses

Primary practice location

505 N Jackson St
Jackson, MI 49201-1266

Mailing address

505 N Jackson St
Jackson, MI 49201-1266
Phone (517) 748-5500

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704220001MIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1346616067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N JACKSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011266",
            "telephone_number": "517-748-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N JACKSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011266",
            "telephone_number": "517-748-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORDEN",
        "first_name": "JENNIFER",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704220001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.