Jeniffer Tobon, ARNP
Individual provider Active NPI Adult Health Nurse Practitioner · Montpelier, VT
NPI 1679768758 · NPPES record last updated Jan 14, 2021
Key facts
- NPI
- 1679768758
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 101.0134154 (VT)
- Practice address
- 1 National Life Dr
Montpelier, VT 05604-9516 - Phone
- (802) 229-7515
- Fax
- (802) 229-7518
- NPI assigned
- Sep 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wound Care Experts of America LLC
Practice addresses (Care Compare)
33333 Dequindre Rd
Troy, MI 48083-4602
Phone (502) 322-7622
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- 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 |
|---|---|---|---|---|
| I20260522002424 | MI | Practitioner - Nurse Practitioner | 1759475544 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| In Home Primary Care, PLLC | Past |
Accepting new patients |
Interoperability endpoints
- jeniffertobon@direct.meditouchehr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 101.0134154 | VT | Yes |
Addresses
Primary practice location
1 National Life Dr
Montpelier, VT 05604-9516
Mailing address
496 S Craftsbury Rd
Craftsbury, VT 05826-9002
Phone (206) 303-0094
Other practice location 1
130 Fisher Rd
Berlin, VT 05602-9516
Phone (802) 371-4316
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101.0134154 | Other | VT | STATE LICENSE |
| 9653841 | Medicaid | WA |
Other providers in Montpelier, VT
- Heidi Louise Thompson
- Ronald Edward Thompson
- Tamella K. Thygesen
- Laura Timmkreitzer
- Demaris Tisdale
- Leslee G Tocci
- Gregory Tomasulo
- Jenjira M Townsend
- Treatment Associates, Inc
- Treatment Associates, LLP
All providers in Montpelier, VT · Adult Health Nurse Practitioner in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2021. 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.