Individual provider Active NPI

Jennifer Stokes

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1710411749
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017501 Issued in PA
Practice address
4700 Wissahickon Ave
Philadelphia, PA 19144-4248
Phone
(215) 843-9720
NPI assigned
Apr 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP017501 PA Primary
Registered Nurse 163W00000X L1-0047728 DE
Registered Nurse 163W00000X RN464196 PA
Nurse Practitioner 363L00000X LG-0001038 DE

Addresses

Primary practice location

4700 Wissahickon Ave
Philadelphia, PA 19144-4248

Mailing address

4700 Wissahickon Ave
Philadelphia, PA 19144-4248
Phone (215) 843-9720

Other practice location 1

1802 W 4th St
Wilmington, DE 19805-3420
Phone (302) 655-5822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230217000974 PA Practitioner - Nurse Practitioner 2567732670 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
L1-0047728DEMDRegistered Nurse
RN464196PAMDRegistered Nurse
LG-0001038DEMDNurse Practitioner
SP017501PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mazzoni Center CurrentSince Jan 1, 2023 Accepting new patients
Jefferson University Physicians PastSince Jan 1, 2023 Accepting new patients

Locations

1348 Bainbridge St
Philadelphia, PA 19147
Phone (215) 563-0652

1201 Locust St
Philadelphia, PA 19107
Phone (215) 985-9206

Interoperability endpoints

  • Direct secure messaging: jennifer.stokes.1@2819.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1710411749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WISSAHICKON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444248",
            "telephone_number": "215-843-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WISSAHICKON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444248",
            "telephone_number": "215-843-9720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 W 4th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198053420",
            "country_code": "US",
            "telephone_number": "302-655-5822",
            "fax_number": "302-322-6251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOKES",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017501",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0047728",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN464196",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0001038",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.