Individual provider Active NPI

Jessica Lynne Christensen, FNP

  • Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1457913162
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP-61930 Issued in ID
Practice address
1880 John Adams Pkwy
Idaho Falls, ID 83401-4315
Phone
(208) 524-6633
Fax
(208) 528-2978
NPI assigned
Jul 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP-61930 ID Primary

Addresses

Primary practice location

1880 John Adams Pkwy
Idaho Falls, ID 83401-4315

Mailing address

1880 John Adams Pkwy
Idaho Falls, ID 83401-4315
Phone (208) 524-6633

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bakerwallace@qwestoffice.net Direct Wallace C Baker

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20191204001273 ID Practitioner - Nurse Practitioner 0446683577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wallace C BakerGroup PAC ID 0446208904, 6 clinicians

Practice addresses (Care Compare)

1880 John Adams Pkwy
Idaho Falls, ID 83401-4315
Phone (208) 524-6633

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP-61930IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wallace C Baker Family Medicine CurrentSince Sep 24, 2019 Accepting new patients

Locations

1880 John Adams Pkwy
Idaho Falls, ID 83401
Phone (208) 524-6633

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.

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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1457913162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 JOHN ADAMS PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014315",
            "telephone_number": "208-524-6633",
            "fax_number": "208-528-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 JOHN ADAMS PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014315",
            "telephone_number": "208-524-6633",
            "fax_number": "208-528-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "JESSICA",
        "middle_name": "LYNNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "CNP-61930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bakerwallace@qwestoffice.net",
            "affiliation": "Y",
            "endpointDescription": "office email",
            "affiliationName": "Wallace C Baker",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1880 John Adams Pkwy",
            "city": "Idaho Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834014315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.