Jenna Nichols

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71014206A Issued in IN

Practice address

1306 E 7TH St Ste a
Auburn, IN 46706-2537

Phone

(260) 925-1255

Fax

(260) 925-1256

NPI assigned

Jul 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in IN

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

Merit-based Incentive Payment System (MIPS)

Final score

83.53 of 100Reported as group

Quality

70

Promoting interoperability

100

Improvement activities

40

Cost

75.11

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jnichols574425@direct.parkviewexchange.com

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.

• Cameron Memorial Community Hospital, Inc

  • Family Medicine Physician
  • Angola, IN
  • NPI 1770521478
  Medicare reassignment NPD
• Cameron Memorial Community Hospital, Inc.

  • Critical Access Hospital
  • Angola, IN
  • NPI 1386683316
  Medicare reassignment NPD
• Cameron Memorial Community Hospital Inc

  • Rural Health Clinic/Center
  • Angola, IN
  • NPI 1326531179
  NPD (past)
• Dekalb Memorial Hospital, Inc

  • General Acute Care Hospital
  • Auburn, IN
  • NPI 1902897937
  NPD (past)

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1558042820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 E 7TH ST STE A",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467062537",
            "telephone_number": "260-925-1255",
            "fax_number": "260-925-1256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IN",
            "license": "28248429A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71014206A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jnichols574425@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "1306 E 7th St Ste A",
            "city": "Auburn",
            "state": "IN",
            "country_code": "US",
            "postal_code": "467062537",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1306 E 7th St Ste A",
            "city": "Auburn",
            "state": "IN",
            "country_code": "US",
            "postal_code": "467062537",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1306 E 7th St Ste A",
            "city": "Auburn",
            "state": "IN",
            "country_code": "US",
            "postal_code": "467062537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrew Stephen Misner, DPT
• Liaamia Moore, LMHC
• Douglas C. Morrow, O.D.
• Beth Nagel, PTA
• Kyla R. Neely, MSW
• Britte Nihart, CNM
• Northeast Indiana Urology PC
• Northeastern Center, Inc
• Northern Anesthesia Providers, LLC
• Northern Brace Company Inc

• Nurse Practitioner in Auburn, IN
• Providers in Auburn, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.