Jessica N Bekkering, FNP
Individual provider Active NPI Family Nurse Practitioner · Clinton, IN
NPI 1700301090 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1700301090
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71007439A (IN)
- Practice address
- 777 S Main St Ste 100
Clinton, IN 47842-2493 - Phone
- (765) 828-1003
- NPI assigned
- Aug 8, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- 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 |
|---|---|---|---|---|
| I20171130001395 | IN | Practitioner - Nurse Practitioner | 8527325471 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28199557A | IN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FC Indiana, LLC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| FC Indiana, LLC | Current |
Accepting new patients |
Locations
2418 16th St
Bedford, IN 47421
Phone (812) 278-3154
4152 W State Road 56
Hanover, IN 47243
Phone (812) 762-4510
815 N Lincoln Rd
Rockville, IN 47872
Phone (337) 282-1096
Interoperability endpoints
- jessica.bekkering.1@23284.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28199557A | IN | |
| Family Nurse Practitioner | 363LF0000X | 71007439A | IN | Yes |
Addresses
Primary practice location
777 S Main St Ste 100
Clinton, IN 47842-2493
Mailing address
777 S Main St Ste 100
Clinton, IN 47842-2493
Phone (765) 828-1003
Other providers in Clinton, IN
- Aa&S Health
- Allied Community Transportation, LLC
- Gary Owen Anderson
- Associated Physicians & Surgeons Clinic, LLC
- Nichole Lynn Barnett
- Binder Chiropractic
- Binder Health LLC
- Maranda Birmingham
- Christie Blackburn
- Teal Brannan
All providers in Clinton, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.