Active NPI
Jennifer Rachelle Vandeloecht, RN
- Registered Nurse
- Jefferson City, MO
National Provider Identifier
1437729845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 2008004535
- Practice address
- 1306 W Main St
Jefferson City, MO 65109-1356 - Phone
- (573) 644-6344
- Fax
- (573) 644-6342
- NPI assigned
- Jun 28, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2008004535 | MO | Primary |
Addresses
Primary practice location
1306 W Main St
Jefferson City, MO 65109-1356
Mailing address
1306 W Main St
Jefferson City, MO 65109-1356
Phone (573) 644-6344
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356556625 | Other | MO | NATIONAL PROVIDER NUMBER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | 573-644-6342 | Other | Lutheran Senior Services |
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2008004535 | MO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624838400000",
"number": "1437729845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1306 W MAIN ST",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651091356",
"telephone_number": "573-644-6344",
"fax_number": "573-644-6342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1306 W MAIN ST",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651091356",
"telephone_number": "573-644-6344",
"fax_number": "573-644-6342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDELOECHT",
"first_name": "JENNIFER",
"middle_name": "RACHELLE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-28",
"last_updated": "2021-06-28",
"certification_date": "2021-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2008004535",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL PROVIDER NUMBER",
"identifier": "1356556625",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "573-644-6342",
"affiliation": "Y",
"endpointDescription": "Saint Joseph's Bluffs secured faxlogic",
"affiliationName": "Lutheran Senior Services",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Secured Fax",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Health Records",
"address_1": "1306 W Main St",
"city": "Jefferson City",
"state": "MO",
"country_code": "US",
"postal_code": "651091356",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.