Individual provider Active NPI

Jenny Ross

  • Family Nurse Practitioner
  • Logansport, IN
National Provider Identifier
1639806870
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28227008A Issued in IN
Practice address
1101 Michigan Ave
Logansport, IN 46947-1528
Phone
(574) 753-1549
Fax
(574) 753-1300
NPI assigned
Aug 8, 2022
Last updated
Aug 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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 28227008A IN Primary

Addresses

Primary practice location

1101 Michigan Ave
Logansport, IN 46947-1528

Mailing address

1281 W 500 S
Peru, IN 46970-7616
Phone (765) 469-4158

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221011001809 IN Practitioner - Nurse Practitioner 2264808567 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28227008AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Logansport Hospital, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Parkview Logansport Hospital, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Memorial Hospital Past Accepting new patients

Locations

1101 Michigan Ave
Logansport, IN 46947
Phone (574) 753-1475

1201 Michigan Ave
Ste 270
Logansport, IN 46947
Phone (574) 722-4921

Interoperability endpoints

  • FHIR API: https://arrprd.mhhcc.org/OAuth2/api/FHIR/R4/
  • FHIR API: https://fhir-myrecord.cerner.com/r4/62ec6f7d-af4b-46d8-93b5-703ae9be8c7e/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1639806870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 W 500 S",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469707616",
            "telephone_number": "765-469-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471528",
            "telephone_number": "574-753-1549",
            "fax_number": "574-753-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JENNY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28227008A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logansport, IN

Sources for this page

Verify at the official NPI Registry.