Active NPI
Jenee Marchetti
- Family Nurse Practitioner
- Goshen, IN
National Provider Identifier
1477177459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71010187A
- Practice address
- 21764 Omega CT
Goshen, IN 46528-7809 - Phone
- (574) 891-4920
- NPI assigned
- Jun 4, 2020
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71010187A | IN | Primary |
Addresses
Primary practice location
21764 Omega CT
Goshen, IN 46528-7809
Mailing address
21764 Omega CT.
Goshen, IN 46528
Phone (574) 891-4920
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71010187A | IN | MD | Family Nurse Practitioner |
Interoperability endpoints
- jenee.bishop@chacc-in.direct.office.nextgen.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1477177459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21764 OMEGA CT.",
"city": "GOSHEN",
"state": "IN",
"postal_code": "46528",
"telephone_number": "574-891-4920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21764 OMEGA CT",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465287809",
"telephone_number": "574-891-4920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCHETTI",
"first_name": "JENEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-04",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71010187A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goshen, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.