Individual provider Active NPI

Elibelle R Jardio, BSN

  • Registered Nurse
  • Stillwater, MN
National Provider Identifier
1346884970
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R166470-4 Issued in MN
Practice address
1740 Overlook TRL N
Stillwater, MN 55082-2520
Phone
(612) 308-1220
Fax
(651) 337-1391
NPI assigned
Nov 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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 R166470-4 MN Primary

Addresses

Primary practice location

1740 Overlook TRL N
Stillwater, MN 55082-2520

Mailing address

1740 Overlook TRL N
Stillwater, MN 55082-2520
Phone (612) 308-1220

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
R166470-4MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Hands at the Cross Care Home LLC CurrentSince Nov 10, 2019 Accepting new patients
Shepherd's Home LLC Current Accepting new patients
Shepherd's Home LLC Current Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1346884970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 OVERLOOK TRL N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550822520",
            "telephone_number": "612-308-1220",
            "fax_number": "651-337-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 OVERLOOK TRL N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550822520",
            "telephone_number": "612-308-1220",
            "fax_number": "651-337-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARDIO",
        "first_name": "ELIBELLE",
        "middle_name": "R",
        "credential": "BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-06",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R166470-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.