Active NPI
Jeanetta Fahrner
- Case Management Agency
- Peoria, IL
National Provider Identifier
1760849202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- Practice address
- 5907 N Aspen Wood Dr Apt 5602
Peoria, IL 61615-8433 - Phone
- (847) 345-5561
- NPI assigned
- Jan 27, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | Primary |
Addresses
Primary practice location
5907 N Aspen Wood Dr Apt 5602
Peoria, IL 61615-8433
Mailing address
PO Box 10752
Peoria, IL 61612-0752
Phone (847) 345-5561
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481068800000",
"number": "1760849202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10752",
"city": "PEORIA",
"state": "IL",
"postal_code": "616120752",
"telephone_number": "847-345-5561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5907 N ASPEN WOOD DR APT 5602",
"city": "PEORIA",
"state": "IL",
"postal_code": "616158433",
"telephone_number": "847-345-5561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAHRNER",
"first_name": "JEANETTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-27",
"last_updated": "2016-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.