Individual provider Active NPI

Bailey Jensen, FNP-BC

  • Family Nurse Practitioner
  • Evanston, WY
National Provider Identifier
1346984184
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
25204 Issued in WY
Practice address
191 Overthrust Rd
Evanston, WY 82930-9261
Phone
(307) 789-8721
Fax
(307) 789-8664
NPI assigned
Apr 27, 2022
Last updated
Apr 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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 25204 WY Primary

Addresses

Primary practice location

191 Overthrust Rd
Evanston, WY 82930-9261

Mailing address

191 Overthrust Rd
Evanston, WY 82930-9261
Phone (307) 789-8721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20220623002798 WY Practitioner - Nurse Practitioner 1850770777 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Wyoming ENT IncGroup PAC ID 0244306678, 2 clinicians
Carver Family Health, LLCGroup PAC ID 1951577485, 2 clinicians

Practice addresses (Care Compare)

191 Overthrust Rd
Evanston, WY 82930-9261
Phone (307) 789-8721

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25204WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carver Family Health, LLC Family CurrentSince May 1, 2022 Accepting new patients
Southwest Wyoming ENT Inc CurrentSince Feb 21, 2024 Accepting new patients

Locations

191 Overthrust Rd
Evanston, WY 82930
Phone (307) 789-0096

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1346984184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 OVERTHRUST RD",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829309261",
            "telephone_number": "307-789-8721",
            "fax_number": "307-789-8664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 OVERTHRUST RD",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829309261",
            "telephone_number": "307-789-8721",
            "fax_number": "307-789-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "BAILEY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "25204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, WY

Sources for this page

Verify at the official NPI Registry.