Jacob Raymond Jellison, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

LG-0001132 Issued in DE

Practice address

4512 Kirkwood Hwy Ste 300
Wilmington, DE 19808-5129

Phone

(302) 623-7500

Fax

(302) 623-7505

NPI assigned

Mar 8, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Christiana Care Health Services IncGroup PAC ID 9739097569, shared by 25 NPIs, 1,480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christianacare Homehealth Home health agency, Wilmington, DE, CCN 087002
• Bayada Home Health Care, Inc Home health agency, Wilmington, DE, CCN 087021
• Christiana Hospital Hospital, Newark, DE, CCN 080001

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Christiana Care Health Services Inc

  • Family Medicine Physician
  • Wilmington, DE
  • NPI 1760811681
  Medicare reassignment NPD
• Christiana Care Health Services, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Wilmington, DE
  • NPI 1770568107
  Medicare reassignment NPD
• Christiana Care Health Services, Inc

  • Family Medicine Physician
  • Hockessin, DE
  • NPI 1134104565
  NPD
• Christiana Care Health Services Inc

  • Neurology Physician
  • Chadds Ford, PA
  • NPI 1881228484
  NPD

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

• Christiana Care Home Health and Community Services, Inc.

  • Home Health Agency
  • Wilmington, DE
  • NPI 1437152154
  Care Compare affiliation Name & address match
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Wilmington, DE
  • NPI 1245277219
  Care Compare affiliation
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Newark, DE
  • NPI 1366473969
  Care Compare affiliation
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • New Castle, DE
  • NPI 1447281043
  Care Compare affiliation
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Milford, DE
  • NPI 1780810424
  Care Compare affiliation
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Wilmington, DE
  • NPI 1821029422
  Care Compare affiliation
• Christiana Care Health Services, Inc.

  • General Acute Care Hospital
  • Wilmington, DE
  • NPI 1134194038
  Care Compare affiliation

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1518469261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR STE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 KIRKWOOD HWY STE 300",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085129",
            "telephone_number": "302-623-7500",
            "fax_number": "302-623-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELLISON",
        "first_name": "JACOB",
        "middle_name": "RAYMOND",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0047847",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0001132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tricia Lynn Jefferson, RD
• Wayne Bernard Jefferson
• Jeffrey S. Meyers, MD and Associates, PA
• Elizabeth Jeker
• Mrudula Jelish, NP
• Jay Ann Jemail, PHD
• Denise A Jenkins
• Kiara Jenkins, BSN, RN
• Jennifer White LLC
• Alison C Jennings, AGPCNP-BC

• Family Nurse Practitioner in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Family Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.