Active NPI
Jodi Lynn Valencia, LPN
- Licensed Practical Nurse
- Morris, IL
National Provider Identifier
1639613532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 043.081258
- Practice address
- 114 E. Benton St.
Morris, IL 60450 - Phone
- (815) 513-5643
- NPI assigned
- Dec 12, 2016
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 043.081258 | IL | Primary |
Addresses
Primary practice location
114 E. Benton St.
Morris, IL 60450
Mailing address
114 E Benton St
Morris, IL 60450-1806
Phone (815) 513-5643
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 |
|---|---|---|---|
| 043.081258 | IL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646179200000",
"number": "1639613532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 E BENTON ST",
"city": "MORRIS",
"state": "IL",
"postal_code": "604501806",
"telephone_number": "815-513-5643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 E. BENTON ST.",
"city": "MORRIS",
"state": "IL",
"postal_code": "60450",
"telephone_number": "815-513-5643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALENCIA",
"first_name": "JODI",
"middle_name": "LYNN",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-12",
"last_updated": "2022-03-02",
"certification_date": "2022-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "IL",
"license": "043.081258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morris, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.