Individual provider Active NPI

Jenny Calhoun

  • Pediatric Nurse Practitioner
  • Newark, DE
National Provider Identifier
1447773163
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
LJ-0000330 Issued in DE
Practice address
4735 Ogletown Stanton Rd Ste 1116
Newark, DE 19713-2089
Phone
(302) 368-8612
NPI assigned
Jul 25, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X L1-0045345 DE
Pediatric Nurse Practitioner 363LP0200X LJ-0000330 DE Primary

Addresses

Primary practice location

4735 Ogletown Stanton Rd Ste 1116
Newark, DE 19713-2089

Mailing address

115 Lauren PL
Newark, DE 19702-2950

Other practice location 1

115 Lauren Place
Newark, DE 19702
Phone (302) 757-3336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20181121000999 DE Order and Referring Only - Nurse Practitioner 5991059347

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1-0045345DEMDRegistered Nurse
LJ-0000330DEMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Past Accepting new patients

Organizations & group practices 1

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": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1447773163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LAUREN PL",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197022950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD STE 1116",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132089",
            "telephone_number": "302-368-8612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Lauren Place",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "19702",
            "country_code": "US",
            "telephone_number": "302-757-3336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALHOUN",
        "first_name": "JENNY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0045345",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "DE",
            "license": "LJ-0000330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.