Individual provider Active NPI

Hannah Marie Slaughter, APRN

  • Pediatric Nurse Practitioner
  • Johnston, IA
National Provider Identifier
1508288275
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
C124818 Issued in IA
Practice address
5406 Merle Hay Road
Childserve Center
Johnston, IA 50131
Phone
(515) 727-8750
Fax
(515) 727-8757
NPI assigned
Jan 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209010870 IL
Pediatric Nurse Practitioner 363LP0200X C124818 IA Primary

Addresses

Primary practice location

5406 Merle Hay Road
Childserve Center
Johnston, IA 50131

Mailing address

5406 Merle Hay Road
Childserve Center
Johnston, IA 50131
Phone (515) 727-8750

Other names 1

  • Hannah Marie Jepson Former name

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
I20201118002008 IA Practitioner - Nurse Practitioner 9638580905 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209010870ILMDNurse Practitioner
C124818IAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Childserve Clinic Inc CurrentSince Oct 1, 2020 Accepting new patients

Locations

5406 Merle Hay Rd
Johnston, IA 50131
Phone (515) 727-8750

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1389657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1508288275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5406 MERLE HAY ROAD",
            "address_2": "CHILDSERVE CENTER",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "50131",
            "telephone_number": "515-727-8750",
            "fax_number": "515-727-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5406 MERLE HAY ROAD",
            "address_2": "CHILDSERVE CENTER",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "50131",
            "telephone_number": "515-727-8750",
            "fax_number": "515-727-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAUGHTER",
        "first_name": "HANNAH",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-14",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209010870",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IA",
            "license": "C124818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "JEPSON",
            "middle_name": "MARIE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnston, IA

Sources for this page

Verify at the official NPI Registry.