Individual provider Active NPI

Jennifer Marie Dobson, C.N.M.

  • Advanced Practice Midwife
  • Rockford, IL
National Provider Identifier
1386712651
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
209004959 Issued in IL
Practice address
1200 W State St
Rockford, IL 61102-2112
Phone
(815) 490-1600
Fax
(815) 490-1485
NPI assigned
Dec 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 209004959 IL Primary

Addresses

Primary practice location

1200 W State St
Rockford, IL 61102-2112

Mailing address

1200 W State St
Rockford, IL 61102-2112
Phone (815) 490-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081209000781 IL Practitioner - Certified Nurse Midwife (CNM) 5991866998 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209004959ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Crusaders Central Clinic Association Current Accepting new patients
Crusaders Central Clinic Association CurrentSince Sep 1, 2008 Accepting new patients
Crusaders Central Clinic Association CurrentSince Sep 1, 2008 Accepting new patients

Locations

1050 Logan Ave
Belvidere, IL 61008
Phone (815) 547-0282

6115 N 2nd St
Loves Park, IL 61111
Phone (815) 516-0040

1100 Broadway
Rockford, IL 61104
Phone (815) 516-0038

1215 N Alpine Rd
Rockford, IL 61107
Phone (815) 391-7700

1200 W State St
Rockford, IL 61102

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

NPI Registry JSON

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1386712651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611022112",
            "telephone_number": "815-490-1600",
            "fax_number": "815-490-1485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611022112",
            "telephone_number": "815-490-1600",
            "fax_number": "815-490-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBSON",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "C.N.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-02",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209004959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.