Jennifer Clerisson, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP025301 Issued in PA

Practice address

74 E Swedesford Rd Ste 150
Malvern, PA 19355-1488

Phone

(877) 210-3188

NPI assigned

Jan 2, 2017

Last updated

Nov 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promed Preferred PA 5 Professional CorporationGroup PAC ID 2769990761, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.clerisson.1@24969.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Promed Preferred PA 5 Professional Corporation

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1053200410

  PA

  Medicare reassignment Care Compare group NPD
• Ennoble HC NJ PC

  • Geriatric Medicine (Family Medicine) Physician
  • Hackensack, NJ
  • NPI 1306500764

  PA

  Medicare reassignment NPD
• Still Waters Clinic,PLLC

  • Primary Care Nurse Practitioner
  • Jenkintown, PA
  • NPI 1255129367
  NPD Authorized official
• Rite Med Group of PA PLLC

  • Internal Medicine Physician
  • Allentown, PA
  • NPI 1962118000
  Medicare reassignment
• Provisions Home Healthcare Services,LLC

  • In Home Supportive Care Agency
  • Philadelphia, PA
  • NPI 1750730586
  NPD (past) Authorized official
• Trinity Health Mid-Atlantic Medical Group

  dba THMA MG Trauma Service Langhorne

  • Trauma Surgery Physician
  • Langhorne, PA
  • NPI 1093771271
  NPD (past)

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

{
    "created_epoch": "1483315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1730624651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 E SWEDESFORD RD STE 150",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551488",
            "telephone_number": "877-210-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 E SWEDESFORD RD STE 150",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551488",
            "telephone_number": "877-210-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLERISSON",
        "first_name": "JENNIFER",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-02",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP025301",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN669412",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louis Joseph Ciliberti Jr., DPM, MS
• Suzanne Maria Clancy, M.P.T.
• Karen Clark-Schock, PSYD
• Nichol Victoria Clark
• Julianne Clarke, CRNP
• Community Services of Devereux
• Compounding RX Apothecary
• Comprehensive Behavioral Health, LLC
• Julian Conejo Gutierrez
• Jessica W Connell, CRNP

• Family Nurse Practitioner in Malvern, PA
• Providers in Malvern, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.