Individual provider Active NPI

Brittany L Jerger

  • Registered Nurse
  • Mount Vernon, IL
National Provider Identifier
1407470206
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041417075 Issued in IL
Practice address
1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone
(618) 242-4600
NPI assigned
Jun 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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 041417075 IL Primary

Addresses

Primary practice location

1 Good Samaritan Way
Mount Vernon, IL 62864-2402

Mailing address

5090 Moake School Rd
Marion, IL 62959-6168
Phone (812) 568-6609

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

State licenses

LicenseStateTypeSpecialty
041417075ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1407470206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5090 MOAKE SCHOOL RD",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629596168",
            "telephone_number": "812-568-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GOOD SAMARITAN WAY",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642402",
            "telephone_number": "618-242-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERGER",
        "first_name": "BRITTANY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041417075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.