Individual provider Active NPI

Jacob Kwyn Ernst

  • Family Nurse Practitioner
  • West Burlington, IA
National Provider Identifier
1447061353
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A182849 Issued in IA
Practice address
1706 W Agency Rd
West Burlington, IA 52655-1667
Phone
(319) 768-5858
NPI assigned
Jan 20, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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 A182849 IA Primary

Addresses

Primary practice location

1706 W Agency Rd
West Burlington, IA 52655-1667

Mailing address

5171 Deerfield Dr
Burlington, IA 52601-2507
Phone (319) 252-3221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20250318001404 IA Practitioner - Nurse Practitioner 8527580760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1706 W Agency Rd
West Burlington, IA 52655-1667
Phone (319) 768-5858

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A182849IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of Southeastern Iowa, Inc CurrentSince Mar 10, 2025 Accepting new patients
Community Health Centers of Southeastern Iowa Inc CurrentSince Mar 10, 2025 Accepting new patients

Locations

1706 W Agency Rd
West Burlington, IA 52655
Phone (319) 768-5858

Interoperability endpoints

  • Direct secure messaging: jernst695501@direct.ochin.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1737331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1447061353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 DEERFIELD DR",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526012507",
            "telephone_number": "319-252-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 W AGENCY RD",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551667",
            "telephone_number": "319-768-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNST",
        "first_name": "JACOB",
        "middle_name": "KWYN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A182849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Burlington, IA

Sources for this page

Verify at the official NPI Registry.