Individual provider Active NPI

Jessica Nicole Whiteman, APRN

  • Nurse Practitioner
  • Saint Joseph, MO
National Provider Identifier
1508477688
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2020025753 Issued in MO
Practice address
5001 Lake Ave
Saint Joseph, MO 64504-1170
Phone
(816) 238-7788
NPI assigned
Aug 12, 2020
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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 2020025753 MO Primary

Addresses

Primary practice location

5001 Lake Ave
Saint Joseph, MO 64504-1170

Mailing address

5001 Lake Ave
Saint Joseph, MO 64504-1170
Phone (816) 238-7788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20231030002327 MO Practitioner - Nurse Practitioner 4183036239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Health Services IncGroup PAC ID 7113835174, 19 clinicians

Practice addresses (Care Compare)

5001 Lake Ave
Saint Joseph, MO 64504-1170
Phone (816) 271-8265

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020025753MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Health Services Inc CurrentSince Sep 19, 2023 Accepting new patients
Northwest Health Services Inc Current Accepting new patients
Northwest Health Services Inc CurrentSince Sep 19, 2023 Accepting new patients

Locations

2303 Village Dr
Saint Joseph, MO 64506
Phone (816) 232-6818

5001 Lake Ave
Saint Joseph, MO 64504
Phone (816) 238-7788

5026 Faraon St
Saint Joseph, MO 64506
Phone (816) 279-1591

Organizations & group practices 3

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 3

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": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1508477688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 LAKE AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645041170",
            "telephone_number": "816-238-7788",
            "fax_number": "816-238-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 LAKE AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645041170",
            "telephone_number": "816-238-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEMAN",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2020025753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.