Active NPI
Jenna Elizabeth Bednarski
- Pediatric Nurse Practitioner
- Lafayette, IN
National Provider Identifier
1578056842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 28228337A
- Practice address
- 3741 Rome Dr Ste B
Lafayette, IN 47905-4490 - Phone
- (765) 607-6160
- Fax
- (765) 607-6161
- NPI assigned
- Jun 12, 2018
- Last updated
- Jun 12, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 28228337A | IN | Primary |
Addresses
Primary practice location
3741 Rome Dr Ste B
Lafayette, IN 47905-4490
Mailing address
3741 Rome Dr Ste B
Lafayette, IN 47905-4490
Phone (765) 607-6160
Other practice location 1
419 E Lincoln Rd
Kokomo, IN 46902-3716
Phone (765) 864-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28228337A | Other | IN | RN LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28228337A | IN | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joint Heirs Pediatrics LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Healthy Horizons Pediatrics
- Pediatrics Physician
- Kokomo, IN
- NPI 1164859880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528761600000",
"number": "1578056842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3741 ROME DR STE B",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479054490",
"telephone_number": "765-607-6160",
"fax_number": "765-607-6161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3741 ROME DR STE B",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479054490",
"telephone_number": "765-607-6160",
"fax_number": "765-607-6161"
}
],
"practiceLocations": [
{
"address_1": "419 E Lincoln Rd",
"address_purpose": "LOCATION",
"city": "Kokomo",
"state": "IN",
"postal_code": "469023716",
"country_code": "US",
"telephone_number": "765-864-2400",
"fax_number": "765-864-2401",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BEDNARSKI",
"first_name": "JENNA",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-12",
"last_updated": "2018-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "IN",
"license": "28228337A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "28228337A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.