Jacqueline Degen, AGACNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN.CNP.023831 Issued in OH

Practice address

580 Lincoln Park Boulevard
Suite 320
Kettering, OH 45429-3493

Phone

(937) 299-6980

NPI assigned

Sep 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Internal Medicine Associates, PCGroup PAC ID 7113830688, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Van Wert County Hospital Hospital, Van Wert, OH, CCN 360071

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Northeast Internal Medicine Associates, PC

  • Internal Medicine Physician
  • Lagrange, IN
  • NPI 1174518500

  Nurse Practitioner, OH

  Medicare reassignment Care Compare group NPD (past)
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  Nurse Practitioner

  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Northeast Internal Medicine Associates, PC

  • Primary Care Nurse Practitioner
  • Lagrange, IN
  • NPI 1366859779
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Van Wert County Hospital Association

  • General Acute Care Hospital
  • Van Wert, OH
  • NPI 1942267760
  Care Compare affiliation

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1508416173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 236",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467610236",
            "telephone_number": "260-463-2133",
            "fax_number": "260-463-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 LINCOLN PARK BOULEVARD",
            "address_2": "SUITE 320",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293493",
            "telephone_number": "937-299-6980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "433 W High St",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "OH",
            "postal_code": "435061690",
            "country_code": "US",
            "telephone_number": "260-463-2133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEGEN",
        "first_name": "JACQUELINE",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.023831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David De la Pena, D.O.
• Katherine Suzanne De la Pena
• Harold D Deal, PA
• Meghan Dean, CNP
• Jessica C Decker, NP
• Timothy Dekoninck, M.D.
• Maria Delgado-Hachey, PH.D.
• Abigail Denlinger, PA-C
• Latonya Y Denson, CRNA
• Marjorie Yvonne Derksen, RN,CNS

• Nurse Practitioner in Kettering, OH
• Providers in Kettering, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.