Individual provider Active NPI

Jillian Marie Armentrout, ACNP-BC

  • Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1750699310
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN252978 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 334-3278
NPI assigned
Sep 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN252978 MA
Nurse Practitioner 363L00000X RN252978 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other names 1

  • Jillian Marie Barnes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20110413000260 MA Practitioner - Nurse Practitioner 0547444739 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Center, Inc CurrentSince Aug 3, 2023 Accepting new patients
Umass Memorial Medical Center, Inc. CurrentSince Aug 3, 2023 Accepting new patients
Umass Memorial Medical Center, Inc. Current Accepting new patients

Locations

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 4

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": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1750699310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMENTROUT",
        "first_name": "JILLIAN",
        "middle_name": "MARIE",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-16",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN252978",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN252978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "BARNES",
            "middle_name": "MARIE",
            "credential": "ACNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.