Individual provider Active NPI

Jennifer Wood, NP-C

  • Family Nurse Practitioner
  • Rolla, MO
National Provider Identifier
1689487142
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2026003035 Issued in MO
Practice address
603 S Bishop Ave
Rolla, MO 65401-4320
Phone
(573) 426-4411
Fax
(573) 426-4403
NPI assigned
Jan 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 260574 WI
Family Nurse Practitioner 363LF0000X 2026003035 MO Primary

Addresses

Primary practice location

603 S Bishop Ave
Rolla, MO 65401-4320

Mailing address

1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000

Other practice location 1

1000 GW Ln
Waynesville, MO 65583-2339
Phone (573) 842-4116

Other practice location 2

1715 N Clarence Ave
Arlington Heights, IL 60004-4025
Phone (847) 971-0671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20260310001059 MO Practitioner - Nurse Practitioner 5799268694 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pcrmc Medical Group IncGroup PAC ID 1557454063, 113 clinicians

Practice addresses (Care Compare)

1000 GW LN
Waynesville, MO 65583-2339
Phone (573) 842-4116

1000 N Jefferson St
Saint James, MO 65559-1078
Phone (573) 265-8840

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
260574WIMDRegistered Nurse
2026003035MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Phelps County Regional Medical Center CurrentSince Mar 23, 2026 Accepting new patients
Pcrmc Medical Group, Inc CurrentSince Mar 23, 2026 Accepting new patients
Phelps County Regional Medical Center CurrentSince Mar 23, 2026 Accepting new patients

Locations

603 S Bishop Ave
Rolla, MO 65401
Phone (573) 426-4411

1050 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1000 Gw Ln
Waynesville, MO 65583
Phone (573) 774-2715

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1689487142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-364-9000",
            "fax_number": "573-426-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S BISHOP AVE",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654014320",
            "telephone_number": "573-426-4411",
            "fax_number": "573-426-4403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 GW Ln",
            "address_purpose": "LOCATION",
            "city": "Waynesville",
            "state": "MO",
            "postal_code": "655832339",
            "country_code": "US",
            "telephone_number": "573-842-4116",
            "fax_number": "573-433-2008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1715 N Clarence Ave",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600044025",
            "country_code": "US",
            "telephone_number": "847-971-0671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "JENNIFER",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-29",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "260574",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2026003035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

Verify at the official NPI Registry.