Isaiah Jernberg, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

12012105A Issued in IN

Practice address

1436 Locust St
Terre Haute, IN 47807-1648

Phone

(812) 878-2316

NPI assigned

May 19, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Wabash Valley Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Terre Haute, IN
  • NPI 1376974527
  NPD (past)

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1679984199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 LOCUST ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478071648",
            "telephone_number": "812-878-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 LOCUST ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478071648",
            "telephone_number": "812-878-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERNBERG",
        "first_name": "ISAIAH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-19",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012105A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asieavae M Jeffers
• Jeffery a Bollenbacher DO PSC
• Lauren Jenkins, OD
• Gregory D. Jennings, DDS
• Julia Jensen
• Sherri Kay Jernberg, FNP
• You-Chuan Jin, MBBS
• John Barton, LPT
• John of Lynns Terre Haute Phcy LLC
• John W. Gonzalez, MD Inc

• Dentist in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.