Jamie Jellison
Individual provider Active NPI Nurse Practitioner · Pratt, KS
NPI 1669833125 · NPPES record last updated Mar 11, 2016
Key facts
- NPI
- 1669833125
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 53-77174 (KS)
- Practice address
- 200 Commodore St
Pratt, KS 67124-2903 - Phone
- (620) 672-7451
- Fax
- (620) 672-2113
- NPI assigned
- Mar 11, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 26
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pratt Regional Medical Center Corporation
Stafford County Hospital
Ashland District Hospital
Practice addresses (Care Compare)
200 Commodore St
Pratt, KS 67124-2903
Phone (620) 672-6476
502 S Buckeye St
Stafford, KS 67578-0190
502 S Buckeye St
Stafford, KS 67578-2035
Phone (620) 234-5221
625 Kentucky St
Ashland, KS 67831-3199
Phone (620) 635-2241
Hospital & facility affiliations
- Stafford County Hospital
- Pratt Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.83 of 100
- Quality
- 82.73
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 83.38
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160531001419 | KS | Practitioner - Nurse Practitioner | 1052601242 | Reassigns benefits to 13 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53-77174 | KS | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vigilias LLC | Current |
Accepting new patients | |
| Newman Memorial County Hospital | Current | Accepting new patients | |
| Pratt Regional Medical Center Corporation | Current | Accepting new patients | |
| Stafford County Hospital | Current |
Accepting new patients | |
| Heart of Kansas Family Health Care, Inc. | Current |
Accepting new patients | |
| Pratt Regional Medical Center Corporation | Current |
Accepting new patients | |
| Newman Memorial County Hospital | Current |
Accepting new patients | |
| Stafford County Hospital | Current |
Accepting new patients | |
| Ashland District Hospital | Current |
Accepting new patients | |
| Newman Memorial County Hospital | Current | Accepting new patients | |
| Heart of Kansas Family Health Care, Inc. | Current |
Accepting new patients | |
| Ashland District Hospital | Current |
Accepting new patients | |
| Grisell Memorial Hospital District 1 | Past | Accepting new patients | |
| Grisell Memorial Hospital District 1 | Past | Accepting new patients | |
| Grisell Memorial Hospital District 1 | Past | Accepting new patients |
Locations
625 Kentucky St
#188
Ashland, KS 67831
Phone (620) 635-2241
625 Kentucky St
Ashland, KS 67831
Phone (620) 635-2222
1206 W Frontview St
Ste 203
Dodge City, KS 67801
Phone (620) 225-7710
1206 W Frontview St
Ste 202
Dodge City, KS 67801
Phone (620) 371-6134
1201 W 12th Ave
Emporia, KS 66801
Phone (620) 343-2376
1905 19th St
Great Bend, KS 67530
Phone (620) 792-5700
522 Broadway St
Larned, KS 67550
Phone (620) 804-6007
535 S Freeborn St
Marion, KS 66861
Phone (620) 382-2177
200 Commodore St
Pratt, KS 67124
Phone (620) 672-6476
420 Country Club Rd
Pratt, KS 67124
Phone (620) 672-7415
203 Watson St
Ste 300
Pratt, KS 67124
Phone (620) 672-1002
124 Commodore St
Ste B
Pratt, KS 67124
Phone (620) 393-5661
210 S Vermont Ave
Ransom, KS 67572
Phone (785) 731-2231
502 S Buckeye St
Stafford, KS 67578
Phone (620) 234-5221
412 Grand Ave
Stafford, KS 67578
Phone (620) 234-2700
4723 E Douglas Ave
Wichita, KS 67218
Phone (316) 670-3800
Interoperability endpoints
- https://api.platform.athenahealth.com/20094/brand/1/csg/1/fhir/r4
- https://fhir-myrecord.cerner.com/r4/b7d97c24-76cc-4a74-827a-3cd7c83065ba/
- jamie.jellison.1@14930.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 53-77174 | KS | Yes |
Addresses
Primary practice location
200 Commodore St
Pratt, KS 67124-2903
Mailing address
200 Commodore St
Pratt, KS 67124-2903
Phone (620) 672-7451
Other providers in Pratt, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.