Individual provider Active NPI

Jessica Dean, APN

  • Family Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1609622695
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209029431 Issued in IL
Practice address
401 Roxbury Rd
Rockford, IL 61107-5078
Phone
(815) 484-7810
NPI assigned
Apr 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209029431 IL Primary

Addresses

Primary practice location

401 Roxbury Rd
Rockford, IL 61107-5078

Mailing address

401 Roxbury Rd
Rockford, IL 61107-5078
Phone (815) 484-7810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240808002356 IL Practitioner - Nurse Practitioner 3274070172 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

401 Roxbury Rd
Rockford, IL 61107-5075
Phone (815) 397-7340

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209029431ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jun 9, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Rockford Gastroenterology Associates, LTD. Family CurrentSince Aug 26, 2024 Accepting new patients
Rockford Gastroenterology Associates, LTD. Current Accepting new patients

Locations

109 N Franklin St
Byron, IL 61010
Phone (815) 234-3900

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

401 Roxbury Rd
Rockford, IL 61107
Phone (815) 397-7340

534 Roxbury Rd
Rockford, IL 61107
Phone (815) 381-7005

4682 E Rockton Rd
Ste 102
Roscoe, IL 61073
Phone (815) 397-7340

954 W State St
Sycamore, IL 60178
Phone (815) 895-9144

Interoperability endpoints

  • Direct secure messaging: jessica.deanapn.p1@direct.rga.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1609622695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075078",
            "telephone_number": "815-484-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075078",
            "telephone_number": "815-484-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "JESSICA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209029431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.