Jennie Vandenhouten, AGPCNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN183462 Issued in GA

Practice address

900 Mohawk St Ste E
Savannah, GA 31419-1768

Phone

(912) 925-0067

NPI assigned

Jul 22, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA, SC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Dermatology and Skin Cancer Center, LLCGroup PAC ID 7113980855, 53 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

53.5 of 100Reported as individual

Quality

45.3

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jvandenhouten@gscc.encitedirect.com

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.

• Georgia Dermatology & Skin Cancer Center, LLC

  • Dermatology Physician
  • Dublin, GA
  • NPI 1063460459
  Medicare reassignment Care Compare group NPD
• Sidney P Smith MD PC

  dba georgia skin and cancer clinic

  • Dermatology Physician
  • Savannah, GA
  • NPI 1427039254

  SC

  Medicare reassignment NPD

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1730596743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MOHAWK ST",
            "address_2": "STE E",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191768",
            "telephone_number": "912-925-0067",
            "fax_number": "912-925-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MOHAWK ST STE E",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191768",
            "telephone_number": "912-925-0067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314012917",
            "country_code": "US",
            "telephone_number": "912-527-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDENHOUTEN",
        "first_name": "JENNIE",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN183462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvandenhouten@gscc.encitedirect.com",
            "affiliation": "N",
            "address_1": "900 Mohawk St Ste E",
            "city": "Savannah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "314191768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexandre Pierre Van Biersel
• Kristen Henker Van Houten
• Evan John Van Peursem, MD
• Jonas Alexander Vanags, M.D.
• Alicia Vanbeverhoudt, LCSW
• Broderick Vandenhuevel, RBT
• Vanguard Medical
• Justyce Vann
• Scott W Vann, MD
• Kristen Vanvleck, MOT, OTR/L

• Adult Health Nurse Practitioner in Savannah, GA
• Providers in Savannah, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.